What is "Persistent Pulmonary Hypertension of Newborn? - pulmonary hypertension visual
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Definition
Pathophysiology
Management
Diagnosis
Tuesday, December 8, 2009
Pulmonary Hypertension Visual What Is "Persistent Pulmonary Hypertension Of Newborn?
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Hello,
Wrong section for this problem. I asked the Ministry of Health, could be more answers, but here is a brief explanation and a link that might help is.
Although persistent pulmonary hypertension of the newborn (PPHN) is not common, which can seriously compromise the health of newborns and long-term complications. Fortunately, a better understanding of neonatal lung function and technology of the plight of children affected by this serious disease affecting improved.
The persistent pulmonary hypertension of the newborn is a heart-lung disease characterized by arterial hypoxemia secondary to elevated pulmonary vascular resistance with resultant shunting of pulmonary blood flow in the systemic circulation. Pathophysiologic syndrome has been described as follows:
Persistent pulmonary vascular obstruction
The fetus
Pulmonary vasospasm
Neonatal pulmonary ischemia
Persistent transitional circulation
Treatment - local practices
These patterns of treatment of chronic hypertension of the newborn from the review of relevant literature and clinical consensus. The change may be required, depending on the clinical situation.
Diagnosis
On suspicion of persistent pulmonary hypertension of the newborn, the echocardiographic examination was requested to exclude anatomical heart defects and confirm the presence of pulmonary hypertension. The review also detailed information on the state of total and cardiac-CONTractile function.
Respiratory alkalosis and
These children were usually placed under artificial respiration. The goal of this technique is to assist ventilation and sufficient oxygen supply. Featured mild hypocapnic alkalosis (pH 7.45 to 7.55 and Paco 2 25 to 35 mmHg) in an attempt to dampen hypoxic pulmonary vasoconstriction. The use of high-frequency oscillation ventilation (HFOV) shows that conventional ventilation is not acceptable to the desired blood gas prices and peak inspiratory pressure Varnholt (1992) (Clark, 1994). Treatment of persistent pulmonary hypertension of the newborn without hyperventilation (ventilation sweet), some persons (Wung, 1985 recommended), (Dworetz, 1989)
Alkalosis may also be achieved with an infusion of parenteral agents such as sodium bicarbonate. Can be considered the initial bolus (2-3 mmol / kg / dose). If you can maintain the alkaline conditions in this way, about the continuous infusion of 1-2 mmol / kg / hour can be considered. Frequent monitoring of serum sodium was not disclosed.
Sedation and paralysis
These children are often very busy and often breathe out of phase with the ventilator. The use of sedation and paralysis in these children is routine. For reasons both physiological and the human, sedation was provided with a paralysis available. Sedation is by continuous infusion of morphine sulfate provided 10 micrograms / kg / hour. Bolus or continuous infusion of lorazepam can be added for sedation. The paralysis is usually achieved with pancuronium bromide, administered intravenously every 1-3 hours with 0.1-0.2 mg / kg / dose.
See drug list ()
Vasodilators
The use of vasodilator substances can not be recommended at this time due to lack of specificity and efficiency (Gouyon, 1992).
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