Neonatal Pulmonary Hypertension, An Issue of Clinics in Perinatology

1st Edition, Volume 51-1 - February 12, 2024
Editors: Steve Abman, Satyanarayana Lakshminrusimha
Language: English
Hardback ISBN:
9 7 8 - 0 - 4 4 3 - 1 8 4 0 5 - 5
eBook ISBN:
9 7 8 - 0 - 4 4 3 - 1 8 4 0 6 - 2

In this issue of Clinics in Perinatology, guest editors Drs. Satyanarayana Lakshminrusimha and Steve Abman bring their considerable expertise to the topic of Neonatal Pulmonary… Read more

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In this issue of Clinics in Perinatology, guest editors Drs. Satyanarayana Lakshminrusimha and Steve Abman bring their considerable expertise to the topic of Neonatal Pulmonary Hypertension. About one in every 1,250 newborns develop neonatal pulmonary hypertension, and about 25% of survivors will have developmental delays, hearing problems, and/or functional disabilities. In this issue, top experts provide updates to the perinatologist on managing this condition to improve patient outcomes.

Cover image
Title page
Table of Contents
Copyright
Contributors
CME Accreditation Page
Forthcoming Issues
Foreword
Preface
Pulmonary Vascular Regulation in the Fetal and Transitional Lung
Key points
Introduction
Pulmonary circulation: structure and function
Development of the pulmonary vasculature
Transition at birth
Preclinical and clinical applications of pulmonary vascular regulation
Summary
Pathogenesis and Physiologic Mechanisms of Neonatal Pulmonary Hypertension: Preclinical Studies
Key points
Pulmonary vascular development
Persistent pulmonary hypertension of the newborn
Congenital diaphragmatic hernia
Bronchopulmonary dysplasia complicated by pulmonary hypertension
Future directions and research gaps
Targeted Neonatal Echocardiography in the Management of Neonatal Pulmonary Hypertension
Key points
Introduction
Pathophysiology
Management approach
Phenotype-specific framework for management
Case study 1: acute pulmonary hypertension of arterial (classic) origin
Case study 2: acute pulmonary hypertension related to excessive pulmonary blood flow
Summary
Oxygen Targets in Neonatal Pulmonary Hypertension: Individualized, “Precision-Medicine” Approach
Key points
Introduction
Goals of oxygen therapy
Studies in older infants, children, and adults
Summary
Inhaled Nitric Oxide in Neonatal Pulmonary Hypertension
Key points
Introduction
A history: neonatal pulmonary hypertension physiology and nitric oxide
Clinical approach to inhaled nitric oxide therapy: who will benefit?
Dose
Weaning
Duration
Toxicity
Contraindications
Supportive management of pulmonary hypertension
Inhaled nitric oxide beyond early use in near-term and term neonates
Summary
Acknowledgments
Funding
Targeted Therapies for Neonatal Pulmonary Hypertension: Beyond Nitric Oxide
Key points
Introduction
Summary
Asphyxia, Therapeutic Hypothermia, and Pulmonary Hypertension
Key points
Introduction
Terminology
Epidemiology and risk factors
Impact of perinatal asphyxia on pulmonary vascular vasoreactivity
Impact of perinatal asphyxia on myocardial performance
Phenotypic etiopathologies of acute pulmonary hypertension in hypoxic ischemic encephalopathy
Hemodynamics of acute pulmonary hypertension in hypoxic ischemic encephalopathy
Impact of therapeutic hypothermia on acute pulmonary hypertension
Cardiopulmonary assessment and diagnostic approach to acute pulmonary hypertension in hypoxic ischemic encephalopathy
Management of acute pulmonary hypertension in neonates with perinatal asphyxia
Summary
Congenital Diaphragmatic Hernia: Pulmonary Hypertension and Pulmonary Vascular Disease
Key points
Introduction
Pathophysiology
Management
Prognosis—late pulmonary hypertension and cardiorespiratory profile
Summary
Early Pulmonary Hypertension in Preterm Infants
Key points
Introduction
Background
Preterm birth and pulmonary vascular development
Pulmonary vascular reactivity in fetal life
Pulmonary hemodynamics during preterm neonatal transition
Early pulmonary vascular disease in preterm infants
Prevalence of early pulmonary hypertension
Risk factors of early pulmonary hypertension
"Omics" in early pulmonary hypertension of preterm
Hypoxic respiratory failure
Clinical features of early pulmonary hypertension
Diagnostic evaluation
Management
Outcomes
Knowledge gaps and future directions
Summary
Author contributions
Pulmonary Hypertension in Established Bronchopulmonary Dysplasia: Physiologic Approaches to Clinical Care
Key points
Introduction
Pathogenesis of pulmonary vascular disease in bronchopulmonary dysplasia
Selected physiologic aspects of bronchopulmonary dysplasia-pulmonary hypertension
Diagnostic strategies for bronchopulmonary dysplasia-pulmonary hypertension
Selected aspects of care
Associated cardiovascular abnormalities in bronchopulmonary dysplasia-pulmonary hypertension
Summary
Pulmonary Hypertension in Developmental Lung Diseases
Key points
Background
Disorders of the FOXF1 gene and cluster
Disorders of T-box 4 and the fibroblast growth factor 10 pathway
Developmental lung disease in trisomy 21
Neonatal presentation of heritable pulmonary vascular diseases
Differential diagnosis: disorders of the surfactant system and childhood interstitial lung diseases
The contribution of pathology and genetics in precision diagnosis
Acute and long-term management
Summary
Etiology, Diagnosis and Management of Persistent Pulmonary Hypertension of the Newborn in Resource-limited Settings
Key points
Introduction
Epidemiology
Clinical features
Management
Summary
Randomized Controlled Trials of Pulmonary Vasodilator Therapy Adjunctive to Inhaled Nitric Oxide for Persistent Pulmonary Hypertension of the Newborn: A Systematic Review
Key points
Background
Methods
Results
Discussion
Summary
Appendix 1. Specific search terms
Comorbidities and Late Outcomes in Neonatal Pulmonary Hypertension
Key points
Introduction
Outcomes
Summary
Funding

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Neonatal Pulmonary Hypertension, An Issue of Clinics in Perinatology

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Steve Abman

Satyanarayana Lakshminrusimha