Abstract
I. Description
A. Persistent pulmonary hypertension of the newborn (PPHN) is a condition in which pulmonary vascular resistance (PVR) is elevated, usually from a failure of its normal postbirth decline. This leads to a variable degree of right-to-left shunting through persistent fetal channels, the foramen ovale and ductus arteriosus, and resultant hypoxemia. A similar clinical picture can arise from decreased systemic vascular resistance (SVR), or any condition where the PVR:SVR ratio is >1. Originally called persistent fetal circulation (PFC), it was a diagnosis seen in term babies with “clear” lung fields on radiography, profound cyanosis, and a structurally normal heart. Secondary PPHN also occurs in babies with primary pulmonary parenchymal disease or with left ventricular dysfunction.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
Suggested Reading
Davis MD, Donn SM, Ward RM. Administration of inhaled pulmonary vasodilators to the mechanically ventilated neonatal patient. Pediatr Drugs. 2017;19(3):183–92.
Kinsella JP, Shaffer E, Neish SR, et al. Low-dose inhalational nitric oxide in persistent pulmonary hypertension of the newborn. Lancet. 1992;340:818–22.
Konduri GG, Kim UO. Advances in the diagnosis and management of persistent pulmonary hypertension of the newborn. Pediatr Clin N Am. 2009;56:579–600.
Lapointe A, Barrington KJ. Pulmonary hypertension and the asphyxiated newborn. J Pediatr. 2011;158(2 Suppl):e19–24.
Peckham GJ, Fox WW. Physiological factors affecting pulmonary artery pressures in infants with persistent pulmonary hypertension. J Pediatr. 1978;93:1005–110.
Roberts JD, Polaner DM, Lang P, et al. Inhaled nitric oxide in persistent pulmonary hypertension of the newborn. Lancet. 1992;340:818–21.
Roberts K, Stepanovich G, Bhatt-Mehta V, Donn SM. New pharmacologic approaches to bronchopulmonary dysplasia. J Exp Pharmacol. 2021;13:377–96.
Wung JT, James LS, Kilchevsky E, et al. Management of infants with severe respiratory failure and persistence of the fetal circulation, without hyperventilation. Pediatrics. 1985;76:488–93.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2022 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Stepanovich, G., Schumacher, R.E., Donn, S.M. (2022). Persistent Pulmonary Hypertension of the Newborn. In: Donn, S.M., Mammel, M.C., van Kaam, A.H. (eds) Manual of Neonatal Respiratory Care. Springer, Cham. https://doi.org/10.1007/978-3-030-93997-7_71
Download citation
DOI: https://doi.org/10.1007/978-3-030-93997-7_71
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-93996-0
Online ISBN: 978-3-030-93997-7
eBook Packages: MedicineMedicine (R0)