What is "Persistent Pulmonary Hypertension of Newborn?

Question

i need an answer of the ff pattern
Visual Aid
Definition
Pathophysiology
Management
Diagnosis

Answer 1

Hello,

Wrong section to ask this question. I would have asked in the health section, you might get more answers, but here is a short explanation and a link that might help.



Although persistent pulmonary hypertension of the newborn (PPHN) isn't common, it can seriously compromise a newborn's health and have long-term complications. Fortunately, better understanding of newborn lung function and technology has improved the outcome for infants affected by this serious condition.

Answer 2

1

Answer 3

Persistent pulmonary hypertension of the newborn is a cardiopulmonary disorder characterized by systemic arterial hypoxemia secondary to elevated pulmonary vascular resistance with resultant shunting of pulmonary blood flow to the systemic circulation. This pathophysiologic syndrome has been variously described as:



Persistent pulmonary vascular obstruction

Persistent fetal circulation

Pulmonary vasospasm

Neonatal pulmonary ischemia

Persistent transitional circulation





Treatment -- Local Practice



These treatment guidelines for Persistent Hypertension of the Newborn are derived from review of the relevant medical literature and from clinical consensus. Variation may be necessary dependent on the clinical situation.



Diagnosis

When Persistent Pulmonary Hypertension of the Newborn is suspected, echocardiographic examination is requested to rule-out cardiac anatomic defects and confirm the presence of pulmonary hypertension. This examination also provides helpful detail regarding volume status and cardiac contractile function.



Ventilatory Support and Alkalosis

These infants usually have been placed on mechanical ventilatory support. The aim of this support technology is to achieve adequate ventilation and oxygenation. Mild hypocapnic alkalosis is recommended (pH 7.45 - 7.55 and PaCO2 25 - 35 torr) in an attempt to attenuate hypoxic pulmonary vasoconstriction. The use of high frequency oscillatory ventilation (HFOV) may be considered if conventional ventilatory support fails to achieve desired blood gas values at acceptable rates and peak inspiratory pressures {Varnholt, 1992},{Clark, 1994}. Treatment of Persistent Pulmonary Hypertension of the Newborn without hyperventilation (gentle ventilation) has been recommended by some {Wung, 1985},{Dworetz, 1989}



Alkalosis can also be achieved with parenteral infusion of agents such as sodium bicarbonate. Initial bolus dosing can be tried (2-3 mEq/kg/dose). If unable to maintain the alkalotic state in this manner, continuous infusion at 1-2 mEq/kg/hour can be tried. Frequent monitoring of serum sodium levels is indicated.



Sedation and Paralysis

These infants are frequently quite agitated and often breathe out-of-phase with ventilatory support. The use of sedation and paralysis in such infants is routine. For both physiologic and humane reasons, sedation is provided concurrently with paralysis. Sedation is provided by morphine sulphate by continuous infusion starting at 10 micrograms/kg/hour. Bolus or continuous infusion dosing of lorazepam can be added for further sedation. Paralysis is usually achieved with pancuronium bromide administered every 1-3 hours intravenously at 0.1-0.2 mg/kg/dose.

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Vasodilators

The use of vasodilatory agents can not be recommended at this time because of lack of specificity and efficacy {Gouyon, 1992}.



PLS REFER TO THIS LINK BELOW FOR SOME OTHER INFORMATION YOU NEED:

Answer 4

go surf the net,you'll get the best answers

Answer 5

check

http://www.emedicine.com/ped/topic2530.htm



or



http://depts.washington.edu/nicuweb/NICU-WEB/pphn.stm