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Life-threatening PPHN refractory to nitric oxide: proposal for a rational therapeutic algorithm

Persistent pulmonary hypertension of the neonate (PPHN) refractory to inhaled nitric oxide still represents a frequent clinical challenge with negative outcomes in neonatal critical care. Several pulmonary vasodilators have become available thanks to improved understanding of pulmonary hypertension...

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Detalles Bibliográficos
Autores principales: Fortas, Feriel, Di Nardo, Matteo, Yousef, Nadya, Humbert, Marc, De Luca, Daniele
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8179956/
https://www.ncbi.nlm.nih.gov/pubmed/34091748
http://dx.doi.org/10.1007/s00431-021-04138-4
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author Fortas, Feriel
Di Nardo, Matteo
Yousef, Nadya
Humbert, Marc
De Luca, Daniele
author_facet Fortas, Feriel
Di Nardo, Matteo
Yousef, Nadya
Humbert, Marc
De Luca, Daniele
author_sort Fortas, Feriel
collection PubMed
description Persistent pulmonary hypertension of the neonate (PPHN) refractory to inhaled nitric oxide still represents a frequent clinical challenge with negative outcomes in neonatal critical care. Several pulmonary vasodilators have become available thanks to improved understanding of pulmonary hypertension pathobiology. These drugs are commonly used in adults and there are numerous case series and small studies describing their potential usefulness in neonates, as well. New vasodilators act on different pathways, some of them can have additive effects and all have different pharmacology features. This information has never been summarized so far and no comprehensive pathobiology-driven algorithm is available to guide the treatment of refractory PPHN. Conclusion: We offer a rational clinical algorithm to guide the treatment of refractory PPHN based on expert advice and the more recent pathobiology and pharmacology knowledge.
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spelling pubmed-81799562021-06-07 Life-threatening PPHN refractory to nitric oxide: proposal for a rational therapeutic algorithm Fortas, Feriel Di Nardo, Matteo Yousef, Nadya Humbert, Marc De Luca, Daniele Eur J Pediatr Review Persistent pulmonary hypertension of the neonate (PPHN) refractory to inhaled nitric oxide still represents a frequent clinical challenge with negative outcomes in neonatal critical care. Several pulmonary vasodilators have become available thanks to improved understanding of pulmonary hypertension pathobiology. These drugs are commonly used in adults and there are numerous case series and small studies describing their potential usefulness in neonates, as well. New vasodilators act on different pathways, some of them can have additive effects and all have different pharmacology features. This information has never been summarized so far and no comprehensive pathobiology-driven algorithm is available to guide the treatment of refractory PPHN. Conclusion: We offer a rational clinical algorithm to guide the treatment of refractory PPHN based on expert advice and the more recent pathobiology and pharmacology knowledge. Springer Berlin Heidelberg 2021-06-06 2021 /pmc/articles/PMC8179956/ /pubmed/34091748 http://dx.doi.org/10.1007/s00431-021-04138-4 Text en © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Review
Fortas, Feriel
Di Nardo, Matteo
Yousef, Nadya
Humbert, Marc
De Luca, Daniele
Life-threatening PPHN refractory to nitric oxide: proposal for a rational therapeutic algorithm
title Life-threatening PPHN refractory to nitric oxide: proposal for a rational therapeutic algorithm
title_full Life-threatening PPHN refractory to nitric oxide: proposal for a rational therapeutic algorithm
title_fullStr Life-threatening PPHN refractory to nitric oxide: proposal for a rational therapeutic algorithm
title_full_unstemmed Life-threatening PPHN refractory to nitric oxide: proposal for a rational therapeutic algorithm
title_short Life-threatening PPHN refractory to nitric oxide: proposal for a rational therapeutic algorithm
title_sort life-threatening pphn refractory to nitric oxide: proposal for a rational therapeutic algorithm
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8179956/
https://www.ncbi.nlm.nih.gov/pubmed/34091748
http://dx.doi.org/10.1007/s00431-021-04138-4
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