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2009, Número 5

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Rev Mex Pediatr 2009; 76 (5)


Hipertensión pulmonar persistente del recién nacido

Gasque GJJ

Idioma: Español
Referencias bibliográficas: 81
Paginas: 220-230
Archivo PDF: 108.76 Kb.


RESUMEN

La hipertensión pulmonar persistente en el recién nacido es un síndrome ocasionado por una falla respiratoria aguda que causa una elevada morbilidad y mortalidad en los neonatos. Ocurre en 0.5 a 2 de cada 1,000 nacidos vivos. La causa puede ser idiopática o como consecuencia del manejo en terapia prenatal con medicamentos, o por asfixia grave de neumonía, sepsis, o HDC con hipoplasia pulmonar. La terapia convencional incluye: altas concentraciones de oxígeno, ventilación mecánica, sedación, alcalinización, soporte con inotrópicos y coloides para mejorar el gasto cardiaco, vasodilatadores para tratar de disminuir la resistencia vascular pulmonar. El óxido nítrico inhalado mejora la oxigenación en 60% de los casos con HPP grave, sin reducir la mortalidad. Cuando los vasodilatadores pulmonares no son efectivos para mantener una oxigenación adecuada, se usa como terapia de rescate la oxigenación por membrana extracorpórea. A pesar de los avances en el tratamiento, la mortalidad oscila de 10 a 50%, dependiendo de la fisiopatología de la causa desencadenante.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Sola A, Porto R. Hipertensión pulmonar persistente en el recién nacido. En: Sola A, Urman J. Cuidados especiales del feto y recién nacido. Ed. Científica Interamericana. 2001: 1003-19.

  2. Van Marter LJ. Persistent pulmonary hypertension of the newborn. In: Cloherty P, Stark AR. Manual of neonatal care. 6th ed. Lippincott Williams & Wilkins 2008: 438-45.

  3. Gomella TL. Persistent pulmonary hypertension of the newborn. In: Gomella TL, Cunningham MD. Neonatology. Management, procedures, on call problems, diseases and drugs. 5th ed. McGraw-Hill. 2004: 364-370.

  4. Whitsett JA, Pryhuber GS, Rice WR, Warner BB, Wert SE. Persistent pulmonary hypertension of the newborn. In: Avery’s MacDonald MG, Mullett MD, Seshia MMK. Neonatology: pathophysiology and management of the newborn. 6th ed. Lippincott Williams & Wilkins. 2005: 565-9.

  5. Morin FC III, Davis JM. Persistent pulmonary hypertension. In: Spitzer AR. Intensive care of the fetus and neonate. Mosby Year Book Inc 1996: 506-16.

  6. Murphy JD, Vawter GF, Reid LM. Pulmonary vascular disease in fatal meconium aspiration. J Pediatr 1984; 104: 758-62.

  7. Waites KB, Crouse DT, Philips JB 3er, Cannup KC, Cassel GH. Ureoplasmal pneumonia and sepsis associated with persistent pulmonary hypertension of the newborn. Pediatrics 1989; 83: 79-85.

  8. Walther FJ, Benders MI, Leighton JO. Persistent pulmonary hypertension in premature neonates with severe respiratory distress syndrome. Pediatrics 1992; 90: 899-904.

  9. Van Marter LJ, Leviton A, Allred EN, Pagano M, Sullivan KF, Cohen A et al. Persistent pulmonary hypertension of the newborn and smoking and aspirin and nonsteroidal anti-in

  10. flammatory drug consumption during pregnancy. Pediatrics 1996; 97: 658-63.

  11. Thébaud B, Mercier JC, Dinh-Xuan AT. Congenital diaphragmatic hernia a cause of persistent pulmonary hypertension of the newborn which lacks an effective therapy. Biol Neonate 1998; 74(5): 323-36.

  12. Hintz SR, Benitz WE, Halamek LP, Van Meurs KP, Rhine WD. Secondary infection presenting as recurrent pulmonary hypertension. J Perinatol 2000; 20(4): 262-4.

  13. Ostrea EM, Villanueva-Uy ET, Natarajan G, Uy HG. Persistent pulmonary hypertension of the newborn: Pathogenesis, etiology and management. Paediatr Drugs 2006; 8(3): 179-88.

  14. Hageman JR, Adams MA, Gardner TH. Persistent pulmonary hypertension of the newborn. Trends in incidence, diagnosis and management. Am J Dis Child 1984; 138(6): 592-5.

  15. Duara SH, Fox WW. Persistent pulmonary hypertension of the neonate. In: Neonatal Pulmonary Care. 2nd ed. 1990; 19: 461-81.

  16. Hammerman C, Yousefzadeh D, Choi JH, Bui KC. Persistent pulmonary hypertension of the newborn. Managing the unmanageable? Clin Perinatol 1989; 16(1): 137-56.

  17. Walsh-Sukys MC. Persistent pulmonary hypertension of the newborn. The black box revisited. Clin Perinatol 1993; 20(1): 127-43.

  18. Morin FC III, Stenmark KR. Persistent pulmonary hypertension of the newborn. Am J Respir Crit Care Med 1995; 151: 2010-2032.

  19. Philips JB III. Treatment of PPHNS. In: Long WA, Tooley WH, McNamara DG. Fetal and neonatal cardiology. W.B Saunders Company. 1990; 55: 691-701.

  20. Goetzman BW, Milstein JM. Pharmacologic Adjuncts. In: Goldsmith JP, Karotkin EH. Assisted ventilation of the neonate. 3rd ed. 1996; 16: 291-304.

  21. Wung JT, James LS, Kilchevski E, James E. Management of infants with severe respiratory failure and persistence of the fetal circulation, without hyperventilation. Pediatrics 1985; 76: 488-94.

  22. Walsh-Sukys MC, Cornell DJ, Houston LN, Keszler M, Kanto WP. Treatment of persistent pulmonary hypertension of the newborn without hyperventilation. An assessment of diffusion of innovation. Pediatrics 1994; 94: 303-6.

  23. Roberts JD, Shaul PW. Advances in the treatment of persistent pulmonary hypertension of the newborn. Pediatr Clin North Am 1993; 40(5): 983-1004.

  24. Walsh-Sukys MC, Tyson JE, Wright LL, Bauer CR, Korones SB, Stevenson DK et al. Persistent pulmonary hypertension of the newborn in the era before nitric oxide. Practice, variation and outcomes. Pediatrics 2000; 105(1 Pt 1): 14-20.

  25. Walsh MC, Stork EK. Persistent pulmonary hypertension of the newborn. Rational therapy based on pathophysiology. Clin Perinatol 2001; 28(3): 609-27, vii.

  26. Konduri CG. New approaches for persistent pulmonary hypertension of newborn. Clin Perinatol 2004; 31(3): 591-611.

  27. Boden G, Bennet CH. The management of persistent pulmonary hypertension of the newborn. Current Paediatrics 2004; 14: 290-7.

  28. Dudell GG, Jain L. Hypoxic respiratory failure in late preterm infant. Clin Perinatol 2006; 33(4): 803-30.

  29. Abman SH. Recent advances in the pathogenesis and treatment of persistent pulmonary hypertension of the newborn. Neonatology 2007; 91: 283-90.

  30. Weinberger B, Weiss K, Heck DE, Laskin DL, Laskin JL. Pharmacologic therapy of persistent pulmonary hypertension of the newborn. Pharmacol Ther 2001; 89: 67-79.

  31. No Authors listed. Inhaled nitric oxide in full-term and nearly full-term infants with hypoxie respiratory failure. The Neonatal Inhaled Nitric Oxide Study Group. N Engl J Med 1997; 336(9): 597-604.

  32. Davidson D, Barefield ES, Kattwinkel J, Dudell G, Damask M, Straube R et al. Inhaled nitric oxide for the early treatment of persistent pulmonary hypertension of the term newborn: A randomized, double masked, placebo controlled, doce response, multicenter study. The INO/PPHN Study Group. Pediatrics 1998; 10: 325-34.

  33. Sadiq HF, Mantych G, Benawra RS, Devaskar UP, Hocker JR. Inhaled nitric oxide in the treatment of moderate persistent pulmonary hypertension of the newborn: A randomized controlled, multicenter trial. J Perinatol 2003; 23(2): 98-103.

  34. Herrera TR, Concha GP, Holberto CJ, Loera GR, Rodríguez BI. Sildenafil oral como alternativa en el tratamiento de recién nacidos con hipertensión pulmonar persistente. Rev Mex Pediatr 2006; 73(4): 159-63.

  35. Baquero H, Soliz A, Neira F, Venegas ME, Sola A. Oral sildenafil in infants with persistent pulmonary hypertension of the newborn. A pilot randomized blinded study. Pediatrics 2006; 117(4): 1077-83.

  36. Bassler D, Choong K, McNamara P, Kirpalini H. Neonatal persistent pulmonary hypertension treated with milrinona: Four case reports. Biol Neonate 2006; 89: 1-5.

  37. Chotigeat U, Jaratwashirakul S. Inhaled iloprost for severe persistent pulmonary hypertension of the newborn. J Med Assoc Thai 2007; 90(1): 167-70.

  38. Hendricks-Muñoz KD, Walton JP. Hearing loss in infants with persistent fetal circulation. Pediatrics 1988; 81: 650-6.

  39. Bifano EM, Pfannenstiel A. Duration of hyperventilation and outcome in infants with persistent pulmonary hypertension. Pediatrics 1988; 81: 657-61.

  40. Lipkin PH, Davidson D, Spivak L, Straube R, Rhines J, Chang CT. Neurodevelopmental and medical outcomes of persistent pulmonary hypertension in term newborns treated with nitric oxide. J Pediatr 2002; 140(3): 306-10.

  41. Rosenberg AA. Outcome in term infants treated with inhaled nitric oxide. J Pediatr 2002; 140(3): 284-7.

  42. Sola A, Porto R. Hipertensión pulmonar persistente en el recién nacido. En: Sola A, Urman J. Cuidados especiales del feto y recién nacido. Ed. Científica Interamericana. 2001: 1003-19.

  43. Van Marter LJ. Persistent pulmonary hypertension of the newborn. In: Cloherty P, Stark AR. Manual of neonatal care. 6th ed. Lippincott Williams & Wilkins 2008: 438-45.

  44. Gomella TL. Persistent pulmonary hypertension of the newborn. In: Gomella TL, Cunningham MD. Neonatology. Management, procedures, on call problems, diseases and drugs. 5th ed. McGraw-Hill. 2004: 364-370.

  45. Whitsett JA, Pryhuber GS, Rice WR, Warner BB, Wert SE. Persistent pulmonary hypertension of the newborn. In: Avery’s MacDonald MG, Mullett MD, Seshia MMK. Neonatology: pathophysiology and management of the newborn. 6th ed. Lippincott Williams & Wilkins. 2005: 565-9.

  46. Morin FC III, Davis JM. Persistent pulmonary hypertension. In: Spitzer AR. Intensive care of the fetus and neonate. Mosby Year Book Inc 1996: 506-16.

  47. Murphy JD, Vawter GF, Reid LM. Pulmonary vascular disease in fatal meconium aspiration. J Pediatr 1984; 104: 758-62.

  48. Waites KB, Crouse DT, Philips JB 3er, Cannup KC, Cassel GH. Ureoplasmal pneumonia and sepsis associated with persistent pulmonary hypertension of the newborn. Pediatrics 1989; 83: 79-85.

  49. Walther FJ, Benders MI, Leighton JO. Persistent pulmonary hypertension in premature neonates with severe respiratory distress syndrome. Pediatrics 1992; 90: 899-904.

  50. Van Marter LJ, Leviton A, Allred EN, Pagano M, Sullivan KF, Cohen A et al. Persistent pulmonary hypertension of the newborn and smoking and aspirin and nonsteroidal anti-inflammatory drug consumption during pregnancy. Pediatrics 1996; 97: 658-63.

  51. Thébaud B, Mercier JC, Dinh-Xuan AT. Congenital diaphragmatic hernia a cause of persistent pulmonary hypertension of the newborn which lacks an effective therapy. Biol Neonate 1998; 74(5): 323-36.

  52. Hintz SR, Benitz WE, Halamek LP, Van Meurs KP, Rhine WD. Secondary infection presenting as recurrent pulmonary hypertension. J Perinatol 2000; 20(4): 262-4.

  53. Ostrea EM, Villanueva-Uy ET, Natarajan G, Uy HG. Persistent pulmonary hypertension of the newborn: Pathogenesis, etiology and management. Paediatr Drugs 2006; 8(3): 179-88.

  54. Hageman JR, Adams MA, Gardner TH. Persistent pulmonary hypertension of the newborn. Trends in incidence, diagnosis and management. Am J Dis Child 1984; 138(6): 592-5.

  55. Duara SH, Fox WW. Persistent pulmonary hypertension of the neonate. In: Neonatal Pulmonary Care. 2nd ed. 1990; 19: 461-81.

  56. Hammerman C, Yousefzadeh D, Choi JH, Bui KC. Persistent pulmonary hypertension of the newborn. Managing the unmanageable? Clin Perinatol 1989; 16(1): 137-56.

  57. Walsh-Sukys MC. Persistent pulmonary hypertension of the newborn. The black box revisited. Clin Perinatol 1993; 20(1): 127-43.

  58. Morin FC III, Stenmark KR. Persistent pulmonary hypertension of the newborn. Am J Respir Crit Care Med 1995; 151: 2010-2032.

  59. Philips JB III. Treatment of PPHNS. In: Long WA, Tooley WH, McNamara DG. Fetal and neonatal cardiology. W.B Saunders Company. 1990; 55: 691-701.

  60. Goetzman BW, Milstein JM. Pharmacologic Adjuncts. In: Goldsmith JP, Karotkin EH. Assisted ventilation of the neonate. 3rd ed. 1996; 16: 291-304.

  61. Wung JT, James LS, Kilchevski E, James E. Management of infants with severe respiratory failure and persistence of the fetal circulation, without hyperventilation. Pediatrics 1985; 76: 488-94.

  62. Walsh-Sukys MC, Cornell DJ, Houston LN, Keszler M, Kanto WP. Treatment of persistent pulmonary hypertension of the newborn without hyperventilation. An assessment of diffusion of innovation. Pediatrics 1994; 94: 303-6.

  63. Roberts JD, Shaul PW. Advances in the treatment of persistent pulmonary hypertension of the newborn. Pediatr Clin North Am 1993; 40(5): 983-1004.

  64. Walsh-Sukys MC, Tyson JE, Wright LL, Bauer CR, Korones SB, Stevenson DK et al. Persistent pulmonary hypertension of the newborn in the era before nitric oxide. Practice, variation and outcomes. Pediatrics 2000; 105(1 Pt 1): 14-20.

  65. Walsh MC, Stork EK. Persistent pulmonary hypertension of the newborn. Rational therapy based on pathophysiology. Clin Perinatol 2001; 28(3): 609-27, vii.

  66. Konduri CG. New approaches for persistent pulmonary hypertension of newborn. Clin Perinatol 2004; 31(3): 591-611.

  67. Boden G, Bennet CH. The management of persistent pulmonary hypertension of the newborn. Current Paediatrics 2004; 14: 290-7.

  68. Dudell GG, Jain L. Hypoxic respiratory failure in late preterm infant. Clin Perinatol 2006; 33(4): 803-30.

  69. Abman SH. Recent advances in the pathogenesis and treatment of persistent pulmonary hypertension of the newborn. Neonatology 2007; 91: 283-90.

  70. Weinberger B, Weiss K, Heck DE, Laskin DL, Laskin JL. Pharmacologic therapy of persistent pulmonary hypertension of the newborn. Pharmacol Ther 2001; 89: 67-79.

  71. No Authors listed. Inhaled nitric oxide in full-term and nearly full-term infants with hypoxie respiratory failure. The Neonatal Inhaled Nitric Oxide Study Group. N Engl J Med 1997; 336(9): 597-604.

  72. Davidson D, Barefield ES, Kattwinkel J, Dudell G, Damask M, Straube R et al. Inhaled nitric oxide for the early treatment of persistent pulmonary hypertension of the term newborn: A randomized, double masked, placebo controlled, doce response, multicenter study. The INO/PPHN Study Group. Pediatrics 1998; 10: 325-34.

  73. Sadiq HF, Mantych G, Benawra RS, Devaskar UP, Hocker JR. Inhaled nitric oxide in the treatment of moderate persistent pulmonary hypertension of the newborn: A randomized controlled, multicenter trial. J Perinatol 2003; 23(2): 98-103.

  74. Herrera TR, Concha GP, Holberto CJ, Loera GR, Rodríguez BI. Sildenafil oral como alternativa en el tratamiento de recién nacidos con hipertensión pulmonar persistente. Rev Mex Pediatr 2006; 73(4): 159-63.

  75. Baquero H, Soliz A, Neira F, Venegas ME, Sola A. Oral sildenafil in infants with persistent pulmonary hypertension of the newborn. A pilot randomized blinded study. Pediatrics 2006; 117(4): 1077-83.

  76. Bassler D, Choong K, McNamara P, Kirpalini H. Neonatal persistent pulmonary hypertension treated with milrinona: Four case reports. Biol Neonate 2006; 89: 1-5.

  77. Chotigeat U, Jaratwashirakul S. Inhaled iloprost for severe persistent pulmonary hypertension of the newborn. J Med Assoc Thai 2007; 90(1): 167-70.

  78. Hendricks-Muñoz KD, Walton JP. Hearing loss in infants with persistent fetal circulation. Pediatrics 1988; 81: 650-6.

  79. Bifano EM, Pfannenstiel A. Duration of hyperventilation and outcome in infants with persistent pulmonary hypertension. Pediatrics 1988; 81: 657-61.

  80. Lipkin PH, Davidson D, Spivak L, Straube R, Rhines J, Chang CT. Neurodevelopmental and medical outcomes of persistent pulmonary hypertension in term newborns treated with nitric oxide. J Pediatr 2002; 140(3): 306-10.

  81. Rosenberg AA. Outcome in term infants treated with inhaled nitric oxide. J Pediatr 2002; 140(3): 284-7.




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