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1.
Neoreviews ; 25(7): e401-e414, 2024 Jul 01.
Article in English | MEDLINE | ID: mdl-38945970

ABSTRACT

The anatomy, physiology, and hemodynamics of the premature heart vary along the range of gestational ages cared for in neonatal intensive care units, from 22 weeks to term gestation. Clinical management of the preterm neonate should account for this heterogenous development. This requires an understanding of the impact of ex utero stressors on immature and disorganized cardiac tissue, the different state of hemodynamics across intracardiac shunts impacting the natural transition from fetal to neonatal life, and the effects of intensive pharmacologic and non-pharmacologic interventions that have systemic consequences influencing cardiac function. This article provides a review of the increasing but still limited body of literature on the anatomy, hemodynamics, and electrophysiology of the preterm heart with relevant clinical considerations.


Subject(s)
Heart , Infant, Premature , Humans , Infant, Newborn , Heart/physiology , Hemodynamics/physiology
2.
J Perinatol ; 43(10): 1211-1221, 2023 10.
Article in English | MEDLINE | ID: mdl-37543651

ABSTRACT

Meconium aspiration syndrome (MAS) is a complex respiratory disease that continues to be associated with significant morbidities and mortality. The pathophysiological mechanisms of MAS include airway obstruction, local and systemic inflammation, surfactant inactivation and persistent pulmonary hypertension of the newborn (PPHN). Supplemental oxygen and non-invasive respiratory support are the main therapies for many patients. The management of the patients requiring invasive mechanical ventilation could be challenging because of the combination of atelectasis and air trapping. While studies have explored various ventilatory modalities, evidence to date does not clearly support any singular modality as superior. Patient's pathophysiology, symptom severity, and clinician/unit expertise should guide the respiratory management. Early identification and concomitant management of PPHN is critically important as it contributes significantly to mortality and morbidities.


Subject(s)
Meconium Aspiration Syndrome , Persistent Fetal Circulation Syndrome , Pulmonary Surfactants , Female , Humans , Infant, Newborn , Meconium Aspiration Syndrome/complications , Respiration, Artificial/adverse effects , Persistent Fetal Circulation Syndrome/complications , Pulmonary Surfactants/therapeutic use , Morbidity
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