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Lookup NU author(s): Dr David Crossland
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© 2022 Elsevier Ltd. Pulmonary hypertension, conventionally defined by absolute pulmonary artery pressure, is the result of a range of diagnoses that can result in clinical problems in neonatal practice. Causes include persistent pulmonary hypertension of the newborn, congenital heart disease, and left heart dysfunction, as well as the normally high pulmonary artery resistance in neonates. Elucidating the cause of pulmonary hypertension is vital to guide appropriate management. A first principles approach based on hemodynamic calculations provides a framework for the diagnostic work up and subsequent therapy. Central to this is the equation ‘pressure = flow x resistance’ and knowledge of factors contributing to flow and resistance and their impact on pulmonary artery pressure. While formal, accurate, calculation of each element is usually not required or deliverable in small infants, clinical and echocardiographic parameters, combined with an understanding of the interplay between pressure, flow, and resistance, significantly improves the assessment and management of neonatal pulmonary hemodynamics.
Author(s): Jones CB, Crossland DS
Publication type: Review
Publication status: Published
Journal: Seminars in Fetal and Neonatal Medicine
Year: 2022
Volume: 27
Issue: 4
Print publication date: 01/08/2022
Online publication date: 18/06/2022
Acceptance date: 02/04/2018
ISSN (print): 1744-165X
ISSN (electronic): 1878-0946
Publisher: W.B. Saunders Ltd
URL: https://doi.org/10.1016/j.siny.2022.101371
DOI: 10.1016/j.siny.2022.101371