Evidence-Based Guidelines for Acute Stabilization and Management of Neonates with Persistent Pulmonary Hypertension of the Newborn

Molly K. Ball; Ruth B. Seabrook; Elizabeth M. Bonachea; Bernadette Chen; Omid Fathi; Craig A. Nankervis; Ahmed Osman; Amy B. Schlegel; Jacqueline Magers; Taylor Kulpa; Paula Sharpin; Mary Lindsay Snyder; Robert J. Gajarski; Deipanjan Nandi; Carl H. Backes Jr.

doi:10.1055/a-1711-0778

American Journal of Perinatology, Inhaltsverzeichnis

Am J Perinatol 2023; 40(14): 1495-1508
DOI: 10.1055/a-1711-0778

Review Article

Evidence-Based Guidelines for Acute Stabilization and Management of Neonates with Persistent Pulmonary Hypertension of the Newborn

Autoren

Molly K. Ball

¹Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio

²Division of Neonatology, Nationwide Children's Hospital, Columbus, Ohio
Ruth B. Seabrook

¹Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio

²Division of Neonatology, Nationwide Children's Hospital, Columbus, Ohio
Elizabeth M. Bonachea

¹Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio

²Division of Neonatology, Nationwide Children's Hospital, Columbus, Ohio
Bernadette Chen

¹Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio

²Division of Neonatology, Nationwide Children's Hospital, Columbus, Ohio

³Department of Pediatrics Pulmonary Hypertension Group, Center for Perinatal Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio
Omid Fathi

¹Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio

²Division of Neonatology, Nationwide Children's Hospital, Columbus, Ohio
Craig A. Nankervis

¹Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio

²Division of Neonatology, Nationwide Children's Hospital, Columbus, Ohio
Ahmed Osman

¹Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio

²Division of Neonatology, Nationwide Children's Hospital, Columbus, Ohio
Amy B. Schlegel

¹Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio

²Division of Neonatology, Nationwide Children's Hospital, Columbus, Ohio
Jacqueline Magers

⁴Department of Pharmacy, Nationwide Children's Hospital, Columbus, Ohio
Taylor Kulpa

⁵Division of Neonatology Nationwide Children's Hospital Neonatal Intensive Care Unit, Neonatal Service Line, Columbus, Ohio
Paula Sharpin

⁵Division of Neonatology Nationwide Children's Hospital Neonatal Intensive Care Unit, Neonatal Service Line, Columbus, Ohio
Mary Lindsay Snyder

⁵Division of Neonatology Nationwide Children's Hospital Neonatal Intensive Care Unit, Neonatal Service Line, Columbus, Ohio
Robert J. Gajarski

¹Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio

⁶Division of Cardiology, Nationwide Children's Hospital, Columbus, Ohio
Deipanjan Nandi

¹Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio

⁶Division of Cardiology, Nationwide Children's Hospital, Columbus, Ohio
Carl H. Backes Jr.

¹Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio

²Division of Neonatology, Nationwide Children's Hospital, Columbus, Ohio

⁶Division of Cardiology, Nationwide Children's Hospital, Columbus, Ohio

⁷Center for Perinatal Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, Department of Pediatrics, Columbus, Ohio

Abstract

Persistent pulmonary hypertension of the newborn, or PPHN, represents a challenging condition associated with high morbidity and mortality. Management is complicated by complex pathophysiology and limited neonatal specific evidence-based literature, leading to a lack of universal contemporary clinical guidelines for the care of these patients. To address this need and to provide consistent high-quality clinical care for this challenging population in our neonatal intensive care unit, we sought to develop a comprehensive clinical guideline for the acute stabilization and management of neonates with PPHN. Utilizing cross-disciplinary expertise and incorporating an extensive literature search to guide best practice, we present an approachable, pragmatic, and clinically relevant guide for the bedside management of acute PPHN.

Key Points

PPHN is associated with several unique diagnoses; the associated pathophysiology is different for each unique diagnosis.
PPHN is a challenging, dynamic, and labile process for which optimal care requires frequent reassessment.
Key management goals are adequate tissue oxygen delivery, avoiding harm.

Keywords

PPHN - pulmonary vasodilators - neonatal intensive care unit - clinical management

Volltext

Referenzen

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