Book chapter
Chapter 27 - Pathophysiologically based management of pulmonary hypertension of the newborn
Neonatology Questions and Controversies: Neonatal Hemodynamics, pp.514-547
Elsevier, Fourth Edition
2023
DOI: 10.1016/B978-0-323-88073-2.00036-7
Abstract
The primary pathophysiologic event in pulmonary hypertension (PH) is elevated pressure in the pulmonary vascular bed. Consequences of PH include right ventricular dysfunction, dilatation, and hypertrophy due to increased afterload and a reduction in pulmonary blood flow. Several different hemodynamic phenotypes of PH may contribute to hypoxemia and circulatory impairment. Increased pulmonary arterial pressure may occur due to elevated pulmonary vascular resistance; however, it may also be caused by excessive pulmonary blood flow or left ventricular dysfunction. Treatment choices should be based on underlying pathophysiology; therefore comprehensive appraisal of hemodynamics is important in a more precise approach to the underlying cause(s) of cardiorespiratory impairment. Targeted neonatal echocardiography is a valuable adjunct to clinical assessment of PH in newborns and may assist in clinical decision-making. This chapter will review the phenotypic presentations of PH and, with the aid of case scenarios, discuss management strategies guided by individual pathophysiology.
Details
- Title: Subtitle
- Chapter 27 - Pathophysiologically based management of pulmonary hypertension of the newborn
- Creators
- Stephanie M. BoydTrassanee ChatmethakulPatrick J. McNamara
- Resource Type
- Book chapter
- Publication Details
- Neonatology Questions and Controversies: Neonatal Hemodynamics, pp.514-547
- Edition
- Fourth Edition
- DOI
- 10.1016/B978-0-323-88073-2.00036-7
- Publisher
- Elsevier; Amsterdam
- Language
- English
- Date published
- 2023
- Academic Unit
- Stead Family Department of Pediatrics; Neonatology
- Record Identifier
- 9984949225202771
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