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Neonatal pulmonary hypertension
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Abstract
When the normal cardiopulmonary transition fails to occur, the result is persistent
pulmonary hypertension of the newborn. Severe persistent pulmonary hypertension of
the newborn is estimated to occur in 2 per 1000 live-born term infants, and some degree
of pulmonary hypertension complicates the course of >10% of all neonates with respiratory
failure. This review article discusses the vascular abnormalities that are associated
with neonatal pulmonary hypertension, including recognition of its role in severe
bronchopulmonary dysplasia in preterm infants. A systematic review of the evidence
for common therapies including inhaled nitric oxide, high-frequency ventilation, surfactant,
and extracorporeal life support is included. Finally, this field is rapidly evolving,
and the rationale for promising new treatment approaches is reviewed, including inhibition
of phosphodiesterases and scavengers of reactive oxygen species.