Meconium Aspiration Syndrome, Hypoxic-Ischemic Encephalopathy and Therapeutic Hypothermia—A Recipe for Severe Pulmonary Hypertension?
Abstract
:1. Introduction
2. Meconium Aspiration Syndrome and PPHN
3. Hypoxic-Ischemic Encephalopathy and PPHN
3.1. Mechanisms Contributing to PPHN and Cardiac Dysfunction in HIE
3.1.1. Disrupted Fetal to Neonatal Cardiopulmonary Transition
3.1.2. Myocardial Dysfunction
4. MAS, HIE and TH
4.1. MAS and HIE—A Precarious Combination
4.2. Cardiovascular Effects of TH
4.3. Cardiorespiratory Effects of TH
5. Optimal Therapeutic Strategies for PPHN in the Setting of MAS, HIE and TH
5.1. Oxygen Saturation Targets
5.2. Ventilation Strategies, Surfactant and iNO
5.2.1. Surfactant and Inhaled Nitric Oxide
5.2.2. Targets for pH and PaCO2
5.2.3. Sodium Bicarbonate
5.3. Systemically Administered Pulmonary Vasodilators
5.3.1. Sildenafil
5.3.2. Milrinone
5.3.3. Prostaglandin I2 (PGI2)
5.3.4. Bosentan
5.3.5. Riociguat
5.4. Management of Systemic Hypotension in PPHN in MAS and HIE during TH (Figure 6)
5.5. Extracorporeal Membrane Oxygenation
6. Long-Term Outcomes
7. Conclusions
Author Contributions
Funding
Data Availability Statement
Conflicts of Interest
References
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Sankaran, D.; Li, J.R.A.; Lakshminrusimha, S. Meconium Aspiration Syndrome, Hypoxic-Ischemic Encephalopathy and Therapeutic Hypothermia—A Recipe for Severe Pulmonary Hypertension? Children 2024, 11, 673. https://doi.org/10.3390/children11060673
Sankaran D, Li JRA, Lakshminrusimha S. Meconium Aspiration Syndrome, Hypoxic-Ischemic Encephalopathy and Therapeutic Hypothermia—A Recipe for Severe Pulmonary Hypertension? Children. 2024; 11(6):673. https://doi.org/10.3390/children11060673
Chicago/Turabian StyleSankaran, Deepika, Jessa Rose A. Li, and Satyan Lakshminrusimha. 2024. "Meconium Aspiration Syndrome, Hypoxic-Ischemic Encephalopathy and Therapeutic Hypothermia—A Recipe for Severe Pulmonary Hypertension?" Children 11, no. 6: 673. https://doi.org/10.3390/children11060673