Division of Neonatology, Department of Pediatrics, University of Florida, USA.
Division of Neonatology, Department of Pediatrics, University of Iowa, USA.
Semin Fetal Neonatal Med. 2022 Aug;27(4):101368. doi: 10.1016/j.siny.2022.101368. Epub 2022 Jun 11.
Pulmonary hypertension in the neonate is associated with cardiopulmonary disturbances and neurodevelopment morbidity. The patent ductus arteriosus is a persistent fetal shunt that can be pathologic vs supportive in the setting of neonatal pulmonary hypertension. Understanding the underlying pathophysiology of pulmonary hypertension and the cardiopulmonary effects of various phenotypes can guide management in this vulnerable population. In this narrative, we will summarize the physiologic principles of pulmonary hypertension, the impact of the patent ductus arteriosus on various phenotypes, and the utility of serial targeted neonatal echocardiography to individualize clinical assessment and management.
新生儿肺动脉高压与心肺功能障碍和神经发育不良有关。动脉导管未闭是一种持续存在的胎儿分流，如果在新生儿肺动脉高压的情况下，它可能是病理性的而不是支持性的。了解肺动脉高压的潜在病理生理学和各种表型的心肺影响可以指导对这一脆弱人群的管理。在这篇叙述中，我们将总结肺动脉高压的生理原理、动脉导管未闭对各种表型的影响，以及连续有针对性的新生儿超声心动图在个体化临床评估和管理中的应用。
