scholarly journals PH Professional Network: 360-degree Care for the Bronchopulmonary Dysplasia Infant with Pulmonary Hypertension: A Comprehensive Review

2021 ◽  
Vol 20 (4) ◽  
pp. 123-131
Author(s):  
Natalie Villafranco ◽  
Elise Whalen ◽  
Nidhy Varghese
Keyword(s):  
Pulmonary Hypertension ◽  
Bronchopulmonary Dysplasia ◽  
Premature Infants ◽  
Interdisciplinary Team ◽  
Multiple Organ ◽  
Comprehensive Review ◽  
Care Plans ◽  
Professional Network ◽  
Organ Systems ◽  
Poor Outcomes

Premature infants are at risk of developing bronchopulmonary dysplasia and associated pulmonary hypertension. These infants make up a complex group of patients with unique considerations regarding development of lung and vascular disease, comorbidities, and care plans. They are high risk for many complications and poor outcomes due to the severity and complexity of disease. Because of this, a comprehensive approach to care with consideration for multiple organ systems and with an interdisciplinary team of experts is the preferred approach. Here we describe in detail the major considerations in care for these infants.

Pulmonary vein stenosis of ex-premature infants with pulmonary hypertension and bronchopulmonary dysplasia, epidemiology, and survival from a multicenter cohort

2017 ◽  
Vol 52 (8) ◽  
pp. 1063-1070 ◽  
Author(s):  
Linda Mahgoub ◽  
Tarek Kaddoura ◽  
A. Rebecca Kameny ◽  
Paloma Lopez Ortego ◽  
Rachel D. Vanderlaan ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Pulmonary Vein ◽  
Bronchopulmonary Dysplasia ◽  
Premature Infants ◽  
Pulmonary Vein Stenosis ◽  
Multicenter Cohort ◽  
Vein Stenosis

scholarly journals Hemophagocytic Lymphohistiocytosis: A Life Threatening Cytopenic Condition

2021 ◽  
Vol 15 (2) ◽  
pp. 98-102
Author(s):  
Suranjit Kumar Saha ◽  
MM Shahin Ul Islam ◽  
Nasir Uddin Ahmed ◽  
Prativa Saha
Keyword(s):  
Hemophagocytic Lymphohistiocytosis ◽  
Clinical Manifestations ◽  
Specific Treatment ◽  
Gene Mutations ◽  
Multiple Organ ◽  
Treatment Modalities ◽  
Hematopoietic Stem ◽  
Organ Systems ◽  
Life Threatening ◽  
Poor Outcomes

Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening disorder that occurs in many underlying conditions in all age. This is characterized by unbridled activation of cytotoxic T lymphocytes, natural killer (NK) cells and macrophages resulting in raised cytokine level. Those cytokines and immune mediated injury occur in multiple organ systems. It may be primary and secondary. Primary HLH is familial, childhood presentation and associated with gene mutations. Secondary HLH is acquired, adulthood presentation that occurs in infections, malignancies inflammatory and autoimmune diseases etc. Clinical manifestations include fever, splenomegaly, lymphadenopathy, neurologic dysfunction, coagulopathy, features of sepsis etc. Laboratory investigation includes cytopenias, hypertriglyceridemia, hyperferritinemia, abnormal liver function, hemophagocytosis, and diminished NKcell activity. Treatment modalities include immunosuppressive, immunomodulatory agents, cytostatic drugs, T-cell antibodies, anticytokine agents and hematopoietic stem cell transplantation (HSCT). Besides those, aggressive supportive care combined with specific treatment of the precipitating factor can produce better outcome. With treatment more than 50% of children who undergo transplant survive, but adults have quite poor outcomes even with aggressive management. Faridpur Med. Coll. J. 2020;15(2): 98-102

scholarly journals Signaling Pathways Involved in the Development of Bronchopulmonary Dysplasia and Pulmonary Hypertension

Children ◽  
2020 ◽  
Vol 7 (8) ◽  
pp. 100
Author(s):  
Rajamma Mathew
Keyword(s):  
Pulmonary Hypertension ◽  
Growth Factor ◽  
Signaling Pathways ◽  
Bronchopulmonary Dysplasia ◽  
Premature Infants ◽  
Animal Experiments ◽  
Tissue Growth ◽  
Inflammatory Stress ◽  
Fibroblast Growth Factor 10 ◽  
Endothelial Growth Factor

The alveolar and vascular developmental arrest in the premature infants poses a major problem in the management of these infants. Although, with the current management, the survival rate has improved in these infants, but bronchopulmonary dysplasia (BPD) is a serious complication associated with a high mortality rate. During the neonatal developmental period, these infants are vulnerable to stress. Hypoxia, hyperoxia, and ventilation injury lead to oxidative and inflammatory stress, which induce further damage in the lung alveoli and vasculature. Development of pulmonary hypertension (PH) in infants with BPD worsens the prognosis. Despite considerable progress in the management of premature infants, therapy to prevent BPD is not yet available. Animal experiments have shown deregulation of multiple signaling factors such as transforming growth factorβ (TGFβ), connective tissue growth factor (CTGF), fibroblast growth factor 10 (FGF10), vascular endothelial growth factor (VEGF), caveolin-1, wingless & Int-1 (WNT)/β-catenin, and elastin in the pathogenesis of BPD. This article reviews the signaling pathways entailed in the pathogenesis of BPD associated with PH and the possible management.

scholarly journals Bronchopulmonary dysplasia: incidence and severity in premature infants born at high altitude.

2021 ◽  
Author(s):  
Jefferson Buendia ◽  
Cristian Ramieez ◽  
Dione Benjumea
Keyword(s):  
Risk Factors ◽  
Pulmonary Hypertension ◽  
High Altitude ◽  
Bronchopulmonary Dysplasia ◽  
Premature Infants ◽  
Early Recognition ◽  
Clinical Practices ◽  
Severity Levels ◽  
Associated Risk Factors ◽  
Preterm Newborns

Background: Bronchopulmonary dysplasia (BPD) is the most common cause of chronic lung disease in children born prematurely. There is little information about the epidemiology and severity of BPD places with high altitude. This study aimed to evaluate the frequency of BPD severity levels and the associated risk factors with severity in a cohort of preterm newborns ≤34 weeks of gestational age born in Rionegro, Colombia Materials and methods: We carried out a retrospective analytical cohort of preterm newborns without major malformations from Rionegro, Colombia between 2011-2018 admitted to neonatal intensive unit at high altitude (2200m above sea level). The main outcomes were the incidence and severity of bronchopulmonary dysplasia. Results: The bronchopulmonary dysplasia incidence was 25.7% (95% CI, 21.6-29.9). Bronchopulmonary dysplasia was moderate in 62.1% of patients and severe in 26.7%. After modeling regression analysis, the final variables associated with BPD severity levels were: sepsis (OR 2.37 CI 95% 1.04-5.40) and pulmonary hypertension (OR 3.79 CI95% 1.19-12). Conclusion: The incidence of BPD was higher and similar to cities with higher altitudes. In our population, the variables associated with BPD severity levels were: duration of oxygen therapy and pulmonary hypertension. It is necessary to increase the awareness of risk factors, the effect of clinical practices, and early recognition of bronchopulmonary dysplasia to reduce morbidity in patients with this pathology.

Benzyl Alcohol as Preservative for Intravenous Solutions

1984 ◽  
Vol 6 (5) ◽  
pp. 139-157
Keyword(s):  
Benzyl Alcohol ◽  
Premature Infants ◽  
Antibacterial Agent ◽  
Neonatal Intensive Care ◽  
Multiple Organ ◽  
Toxic Effects ◽  
Neonatal Intensive Care Units ◽  
Clinical Syndromes ◽  
Organ Systems ◽  
Eventual Death

Benzyl alcohol is commonly used as an antibacterial agent in a variety of formulations including bacteriostatic sodium chloride and bacteriostatic water. Although benzyl alcohol toxicity has been recognized, the concentration necessary for antibacterial action appears to be much lower than the concentration that would be dangerous to adults. Prior to these reports, little was known about the toxic effects of benzyl alcohol in neonates. The possible toxic effects of benzyl alcohol in neonates were noted when several premature infants in neonatal intensive care units developed similar clinical syndromes, referred to as the "gasping syndrome," characterized by deterioration of multiple organ systems and eventual death.

Placental Villous Vascularity is Decreased in Premature Infants with Bronchopulmonary Dysplasia-Associated Pulmonary Hypertension

2016 ◽  
Vol 19 (2) ◽  
pp. 101-107 ◽  
Author(s):  
Sushmita G. Yallapragada ◽  
Karen K. Mestan ◽  
Hannah Palac ◽  
Nicolas Porta ◽  
Nina Gotteiner ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Bronchopulmonary Dysplasia ◽  
Premature Infants

scholarly journals Systemic Consequences of Pulmonary Hypertension and Right-Sided Heart Failure

Circulation ◽  
2020 ◽  
Vol 141 (8) ◽  
pp. 678-693 ◽  
Author(s):  
Stephan Rosenkranz ◽  
Luke S. Howard ◽  
Mardi Gomberg-Maitland ◽  
Marius M. Hoeper
Keyword(s):  
Heart Failure ◽  
Pulmonary Hypertension ◽  
Structural Changes ◽  
Immune Cell ◽  
Organ Damage ◽  
Multiple Organ ◽  
Clinical Syndrome ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Organ Systems

Pulmonary hypertension (PH) is a feature of a variety of diseases and continues to harbor high morbidity and mortality. The main consequence of PH is right-sided heart failure which causes a complex clinical syndrome affecting multiple organ systems including left heart, brain, kidneys, liver, gastrointestinal tract, skeletal muscle, as well as the endocrine, immune, and autonomic systems. Interorgan crosstalk and interdependent mechanisms include hemodynamic consequences such as reduced organ perfusion and congestion as well as maladaptive neurohormonal activation, oxidative stress, hormonal imbalance, and abnormal immune cell signaling. These mechanisms, which may occur in acute, chronic, or acute-on-chronic settings, are common and precipitate adverse functional and structural changes in multiple organs which contribute to increased morbidity and mortality. While the systemic character of PH and right-sided heart failure is often neglected or underestimated, such consequences place additional burden on patients and may represent treatable traits in addition to targeted therapy of PH and underlying causes. Here, we highlight the current state-of-the-art understanding of the systemic consequences of PH and right-sided heart failure on multiple organ systems, focusing on self-perpetuating pathophysiological mechanisms, aspects of increased susceptibility of organ damage, and their reciprocal impact on the course of the disease.

A New Scoring System For Evaluation of Multiple Organ Dysfunction Syndrome in Premature Infants

2012 ◽  
Vol 21 (5) ◽  
pp. 328-337 ◽  
Author(s):  
Merih Çetinkaya ◽  
Nilgün Köksal ◽  
Hilal Özkan
Keyword(s):  
Organ Dysfunction ◽  
Premature Infants ◽  
Multiple Organ Dysfunction Syndrome ◽  
Respiratory System ◽  
Scoring System ◽  
Multiple Organ ◽  
Gastrointestinal System ◽  
Multiple Organ Dysfunction ◽  
Organ Systems ◽  
The Mean

Background The Neonatal Multiple Organ Dysfunction (NEO-MOD) scoring system is used to predict mortality in infants with multiple organ dysfunction syndrome (MODS). The NEOMOD scoring system was extended to include involvement of the microvascular system. This modified scoring system was developed to enable more accurate and earlier diagnosis of MODS in premature infants. Objective To evaluate the modified NEOMOD scoring system in preterm infants with MODS and compare its effectiveness with the NEOMOD scoring system. Methods This prospective study was performed in a tertiary neonatal intensive care unit. A total of 198 premature infants were enrolled. Infants were evaluated for development of MODS by using the modified NEOMOD scoring system until discharge or death according to clinical and laboratory findings. Infants who had organ dysfunction in 2 or more organ systems had MODS diagnosed. Results In the 160 infants (80.8%) with MODS, the gastrointestinal system, respiratory system, and hematologic system were involved most often. The gastrointestinal system, respiratory system, and acid-base metabolism were involved initially in 99.4%, 86.3%, and 26.3% of infants, respectively. The mean modified NEOMOD score for the infants who died in the first 28 days after birth was significantly higher than the mean score for infants who survived. The number of systems involved was also higher in infants who died. Conclusions The modified NEOMOD scoring system is a safe and accurate tool for determining both mortality rate and dysfunction of multiple organ systems affecting mortality in pre-term infants.

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