Persistent pulmonary arterial hypertension of the newborn.
Indian J Pediatr
;
1992 Nov-Dec; 59(6): 735-9
Article
in English
| IMSEAR
| ID: sea-83628
ABSTRACT
Persistent pulmonary hypertension of the newborn (PPHN) characterised by right to left shunting with intense cyanosis is difficult to manage, and in the best of centres carries a 40-60 percent mortality. We report our one year's experience of managing six neonates with PPHN. There were 5 males and 1 female with mean birth weight of 2.59 +/- 0.487 kg and gestation period 39 +/- 2.0 wks and 1 minute Apgar score 2.8 +/- 2.1. Four to six babies were born by cesarean section and 3-6 babies had aspiration pneumonia. All babies presented within 12 hours of age (mean 5.08 +/- 5 hrs) with intense cyanosis and respiratory distress. Diagnosis were confirmed in all by (a) hyperoxia test, (b) simultaneous determination of preductal and postductal paO2 (c) contrast echocardiography and (d) hyperoxia-hyperventilation test. Babies were managed with hyperventilation using mean ventilatory rates of 100 +/- 45 per minute, an inspired oxygen concentration of 100%, peak inspiratory pressures 27 +/- 9 cm of H2O, and expiratory pressures 5 +/- 1.6 cms of H2O, and mean air way pressures of 10.4 +/- 2.7 cms H2O. Alkali therapy was used in 3 of the six babies whereas low dose dopamine was infused in all six babies. Inspite of aggressive ventilatory therapy, only 3 out of 6 babies could be salvaged.
Full text:
Available
Index:
IMSEAR (South-East Asia)
Main subject:
Respiration, Artificial
/
Birth Weight
/
Female
/
Humans
/
Male
/
Infant, Newborn
/
Echocardiography
/
Intensive Care Units, Neonatal
/
Gestational Age
/
Hypertension, Pulmonary
Language:
English
Journal:
Indian J Pediatr
Year:
1992
Type:
Article
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