scholarly journals Considerations in the management of hypoxemic respiratory failure and persistent pulmonary hypertension in term and late preterm neonates

2016 ◽  
Vol 36 (S2) ◽  
pp. S12-S19 ◽  
Author(s):  
S Lakshminrusimha ◽  
G G Konduri ◽  
R H Steinhorn
Keyword(s):  
Pulmonary Hypertension ◽  
Respiratory Failure ◽  
Late Preterm ◽  
Persistent Pulmonary Hypertension ◽  
Preterm Neonates ◽  
Hypoxemic Respiratory Failure

scholarly journals Efficacy of inhaled nitric oxide in neonates with hypoxic respiratory failure and pulmonary hypertension: the Japanese experience

2018 ◽  
Vol 46 (6) ◽  
pp. 657-663 ◽  
Author(s):  
Satoshi Suzuki ◽  
Hajime Togari ◽  
Jim L. Potenziano ◽  
Michael D. Schreiber
Keyword(s):  
Nitric Oxide ◽  
Pulmonary Hypertension ◽  
Respiratory Failure ◽  
Negative Impact ◽  
Survival Rates ◽  
Oxygenation Index ◽  
Inhaled Nitric Oxide ◽  
Preterm Neonates ◽  
Therapeutic Trial ◽  
Hypoxic Respiratory Failure

AbstractObjective:To analyze data from a registry of Japanese neonates with hypoxic respiratory failure associated with pulmonary hypertension (PH) to compare the effectiveness of inhaled nitric oxide (iNO) in neonates born <34 weeks vs. ≥34 weeks gestational age (GA).Materials and methods:iNO was administered according to approved Japanese product labeling. Study data were collected before iNO administration and at predefined intervals until discontinuation.Results:A total of 1,114 neonates were included (n=431, <34 weeks GA; n=675, ≥34 weeks GA; n=8, missing age data). Mean decrease from baseline oxygenation index (OI) was similar in both age groups. OI reduction was more pronounced in the <34 weeks subgroups with baseline OI ≥25. Survival rates were similar in the <34 weeks GA and ≥34 weeks GA groups stratified by baseline OI (OI<15, 89% vs. 93%; 15≤OI<25, 85% vs. 91%; 25≤OI≤40, 73% vs. 79%; OI>40, 64% vs. 66%).Conclusion:iNO improved oxygenation in preterm neonates as effectively as in late preterm and term neonates, without negative impact on survival. If clinically significant PH is present, as measured by pulse oximetry or echocardiography, a therapeutic trial of iNO might be indicated for preterm neonates.

scholarly journals Challenges, priorities and novel therapies for hypoxemic respiratory failure and pulmonary hypertension in the neonate

2016 ◽  
Vol 36 (S2) ◽  
pp. S32-S36 ◽  
Author(s):  
J L Aschner ◽  
J Gien ◽  
N Ambalavanan ◽  
J P Kinsella ◽  
G G Konduri ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Respiratory Failure ◽  
Novel Therapies ◽  
Hypoxemic Respiratory Failure

scholarly journals Diagnostic importance of natriuretic peptide in chronic obstructive pulmonary disease with chronic hypoxemic respiratory failure

2020 ◽  
Vol 4 (4) ◽  
pp. 174-179
Author(s):  
N.A. Kuzubova ◽  
◽  
O.N. Titova ◽  
V.A. Volchkov ◽  
D.B. Sklyarova ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Hypertension ◽  
Respiratory Failure ◽  
Pulmonary Disease ◽  
Natriuretic Peptide ◽  
Chronic Obstructive ◽  
Hypoxemic Respiratory Failure ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Diagnostic Importance

Background: the progression of chronic obstructive pulmonary disease (COPD) is accompanied by pulmonary hypertension and right ventricular failure as well as left ventricular failure that can be associated with the elevated levels of N-terminal pro b-type natriuretic peptide (NT-proBNP). Aim: to evaluate the diagnostic importance of NT-proBNP in COPD with chronic hypoxemic respiratory failure. Patients and Methods: 60 patients with COPD GOLD stage 3 and 4 (group D, mixed phenotype: emphysematous bronchitic) during remission were examined. Mean age was 64.78±6.9 years. The patients were divided into three groups. Group 1 included 20 COPD patients with hypoxemia who received long-term oxygen therapy (LTOT). Group 2 included 20 COPD patients with hypoxemia who did not receive LTOT. Group 3 included 20 COPD patients with normoxemia. After the primary examination, group 1 patients were prescribed with in-home LTOT (16 hours daily). Group 2 and 3 patients were not prescribed with LTOT. All patients received basic treatment, i.e., a combined drug containing an inhaled corticosteroid and β2-agonist (budesonide/formoterol 400/12 μg twice daily) and a long-acting muscarinic antagonist (tiotropium bromide 2.5 μg, 2 inhalations once daily). The patients were reexamined after 12 months. Arterial blood gases and serum NT-proBNP concentration were measured, spirometry and Doppler echocardiography were performed. Results: NT-proBNP levels in COPD patients with hypoxemia were significantly elevated. The associations between NT-proBNP and partial oxygen arterial pressure (r= -0.71, p<0.05), NT-proBNP and pulmonary artery systolic pressure (PASP) (r=0.61, p<0.05) were revealed. ROC analysis of NT-proBNP demonstrated its sensitivity and specificity in COPD patients with the different severity of respiratory failure. LTOT for COPD with hypoxemia reduces PASP, improves left ventricular diastolic function, and decreases NT-proBNP levels. Conclusions: as chronic hypoxemic respiratory failure progresses in COPD, NT-proBNP concentration increases. ROC analysis demonstrates that NT-proBNP can be considered as a promising marker of hypoxemia and pulmonary hypertension. LTOT reduces NT-proBNP levels by improving pulmonary cardiac hemodynamics. KEYWORDS: COPD, hypoxemia, natriuretic peptide, long-term oxygen therapy, pulmonary hypertension, diastolic dysfunction, right ventricle. FOR CITATION: Kuzubova N.A., Titova O.N., Volchkov V.A., Sklyarova D.B. Diagnostic importance of natriuretic peptide in chronic obstructive pulmonary disease with chronic hypoxemic respiratory failure. Russian Medical Inquiry. 2020;4(4):174–179. DOI: 10.32364/2587-6821- 2020-4-4-174-179.

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