Respiratory Distress In Term Infants: PPHN Flashcards
Is persistent pulmonary hypertension of the newborn life threatening?
Yes
What is it usually associated with?
Birth asphyxia
Meconium aspiration
Sepsis
RDS
Can it occur as a primary disorder?
Sometimes
Due to the high pulmonary vascular resistance, there is…
Right to left shunting
What occurs soon after birth?
Cyanosis
Are heart murmurs and HF signs often present or absent?
Absent
What does a CXR show?
Heart of normal size
There may be pulmonary oligaemia (hypovolaemia)
What is required to confirm diagnosis?
ECHO
Exclude CHD
Identify signs of pulmonary HTN such as raised pulmonary pressures and tricuspid regurgitation
RV dysfunction (suggests severe pulmonary HTN)
Most infants require…
Mechanical ventilation and circulatory support to achieve adequate oxygenation
What potent vasodilator is often beneficial?
Nitric oxide
What alternative to nitric oxide can be used?
Sildenafil (viagra) - also a potent vasodilator
What can be done in severe but reversible cases?
Extracorporeal membrane oxygenation (ECMO) - infant placed on a heart and lung bypass for several days
Why are inotropes often used?
Help keep BP high to help heart pump blood into lungs
What specific type of ventilation can be helpful?
High frequency oscillation - pushes air in and out of lungs very quickly
