scholarly journals PULMONARY HYPERTENSION IN INFANTS WITH BRONCHOPULMONARY DYSPLASIA: CAUSES, DIAGNOSIS, TREATMENT

2021 ◽  
Vol 11 (4(42)) ◽  
pp. 53-59
Author(s):  
A. Menshykova ◽  
D. Dobryanskyy
Keyword(s):  
Pulmonary Hypertension ◽  
Bronchopulmonary Dysplasia ◽  
Total Duration ◽  
Cardiovascular Complication ◽  
Diagnosis And Treatment ◽  
Pulmonary Vasculature ◽  
Vascular Abnormalities ◽  
Duration Of Hospital Stay ◽  
Hypertension In Children

Bronchopulmonary dysplasia (BPD) is a leading chronic pathology of premature infants, which changes the structure of the lungs and disrupts the development of pulmonary vessels. The most important cardiovascular complication of BPD is the development of pulmonary hypertension, which is diagnosed in about 25 % of severely ill infants. Pulmonary hypertension associated with BPD develops due to lung vascular abnormalities and remodeling of the pulmonary vasculature, both of which lead to an increase in vascular resistance and the development of right ventricular heart failure. The occurrence of this complication worsens the prognosis of survival in infants with BPD, prolongs the total duration of hospital stay, adversely affects long-term somatic and neurological development and increases the frequency of re-hospitalizations. All this justifies the need for timely diagnosis and treatment of pulmonary hypertension in children with BPD. This review presents new data, for the definition, diagnosis, and treatment of pulmonary hypertension associated with BPD.

Pulmonary hypertension in infancy and childhood

2003 ◽  
Vol 13 (3) ◽  
pp. 219-227 ◽  
Author(s):  
Matthias Gorenflo ◽  
Mathias Nelle ◽  
Ph. A. Schnabel ◽  
Michael V. Ullmann
Keyword(s):  
Pulmonary Hypertension ◽  
Bronchopulmonary Dysplasia ◽  
Primary Pulmonary Hypertension ◽  
Special Focus ◽  
Morphological Alterations ◽  
Functional Aspects ◽  
Infancy And Childhood ◽  
Long Term Prognosis ◽  
Hypertension In Children

In this review, we discuss current concepts in the pathogenesis and management of pulmonary hypertension affecting infants and children, with special focus on left-to-right shunting, bronchopulmonary dysplasia, and primary pulmonary hypertension.In patients of these ages, functional aspects, such as an imbalance between vasoconstricting and vasodilating mechanisms, and morphological alterations of the vessel wall, contribute to the pulmonary hypertension. In the past decades, strategies have emerged for treatment that are targeted at the pathophysiological basis. Thus, in patients with left-to-right shunting and pulmonary hypertension after intra-cardiac repair, treatment with nitric oxide has been introduced effectively, while treatment with prostanoids, such as iloprost, is under investigation. In patients with pulmonary hypertension and bronchopulmonary dysplasia, therapeutic strategies focus on the underlying chronic lung disease and use of vasodilators. The pathogenesis of primary pulmonary hypertension in children remains as yet unclear, although treatment with prostanoids has proven effectively to improve the long-term prognosis.

scholarly journals EXPRESS: Obituary: Sheila “Glennis” Haworth CBE

2020 ◽  
pp. 204589402098250
Author(s):  
Michael Brown
Keyword(s):  
Pulmonary Hypertension ◽  
Role Model ◽  
Indian Subcontinent ◽  
Diagnosis And Treatment ◽  
Global Impact ◽  
Physician Scientist ◽  
Scientific Networks ◽  
Hypertension In Children ◽  
Research Institute

Sheila “Glennis” Haworth CBE World-renowned paediatric physician scientist who investigated pulmonary hypertension in children and widely recognised for her global impact in improving the diagnosis and treatment of this disease. She was an instrumental co-founder of the Pulmonary Vascular Research Institute (PVRI) in 2006, a role model for all the good that it stands for and its most loyal supporter, declaring her love of this organisation shortly before her death on 23rd October 2020. The links she forged with the Indian Subcontinent on behalf of the PVRI in supporting the development of improved care for patients via establishing clinical and scientific networks is of particular note.

Evaluation and Management of Pulmonary Hypertension in Children with Bronchopulmonary Dysplasia

2017 ◽  
Vol 188 ◽  
pp. 24-34.e1 ◽  
Author(s):  
Usha Krishnan ◽  
Jeffrey A. Feinstein ◽  
Ian Adatia ◽  
Eric D. Austin ◽  
Mary P. Mullen ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Bronchopulmonary Dysplasia ◽  
Hypertension In Children

scholarly journals Pulmonary Vascular Underperfusion Score in Premature Infants with Bronchopulmonary Dysplasia and Pulmonary Hypertension

Medicina ◽  
2019 ◽  
Vol 55 (7) ◽  
pp. 359
Author(s):  
Das ◽  
Jadotte ◽  
Chan
Keyword(s):  
Pulmonary Hypertension ◽  
Bronchopulmonary Dysplasia ◽  
Imaging Modality ◽  
Pulmonary Angiography ◽  
Right Heart Catheterization ◽  
Pulmonary Vasculature ◽  
Heart Catheterization ◽  
Vascular Changes ◽  
Cardiac Hemodynamics ◽  
Underlying Pathophysiology

Pulmonary hypertension (PH) is a complication of bronchopulmonary dysplasia (BPD). The underlying pathophysiology of BPD-associated PH is complex and poorly understood. Echocardiogram may underestimate the severity of pulmonary hypertensive vascular disease in severe BPD. Digital subtraction pulmonary angiography (DSPA) is a potentially useful imaging modality for evaluating changes in the pulmonary vasculature of BPD-associated PH. In this study, we objectively quantified the pulmonary hypertensive vascular changes demonstrated by DSPA using a novel pulmonary vascular underperfusion score (PVUS) and correlated the scoring system with echocardiography parameters and cardiac hemodynamics by right heart catheterization.

scholarly journals Targeting Bronchopulmonary Dysplasia-Associated Pulmonary Hypertension (BPD-PH): Potential Role of the FGF Signaling Pathway in the Development of the Pulmonary Vascular System

Cells ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. 1875
Author(s):  
Cho-Ming Chao ◽  
Lei Chong ◽  
Xuran Chu ◽  
Amit Shrestha ◽  
Judith Behnke ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Signaling Pathway ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Potential Role ◽  
Vascular System ◽  
Point Of View ◽  
Pulmonary Vasculature ◽  
Curative Therapy

More than 50 years after the first description of Bronchopulmonary dysplasia (BPD) by Northway, this chronic lung disease affecting many preterm infants is still poorly understood. Additonally, approximately 40% of preterm infants suffering from severe BPD also suffer from Bronchopulmonary dysplasia-associated pulmonary hypertension (BPD-PH), leading to a significant increase in total morbidity and mortality. Until today, there is no curative therapy for both BPD and BPD-PH available. It has become increasingly evident that growth factors are playing a central role in normal and pathologic development of the pulmonary vasculature. Thus, this review aims to summarize the recent evidence in our understanding of BPD-PH from a basic scientific point of view, focusing on the potential role of Fibroblast Growth Factor (FGF)/FGF10 signaling pathway contributing to disease development, progression and resolution.

scholarly journals The role of the heart team in the diagnosis and treatment of chronic thromboembolic pulmonary hypertension

2020 ◽  
Vol 27 (5) ◽  
pp. 9-21
Author(s):  
L. V. Kulyk ◽  
Yu. M. Sirenko ◽  
G. D. Radchenko ◽  
L. I. Vasylyeva ◽  
I. O. Zhyvylo ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Surgical Treatment ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Diagnosis And Treatment ◽  
Long Term Results ◽  
High Tech ◽  
Heart Team ◽  
Thromboembolic Pulmonary Hypertension ◽  
Team Concept

The aim – to present to the medical community the functioning algorithm of the heart team concept in the diagnosis and surgical treatment of chronic thromboembolic pulmonary hypertension (CTEPH) in Ukraine. The concept of the CTEPH team implies a multi-disciplinary approach to the diagnosis and, consequently, surgical treatment of CTEPH with the participation of a radiologist, a pulmonologist, a cardiologist, a hematologist, a neurologist, and a cardiac surgeon. Considering the low incidence of the disease, the need for high-tech diagnostic tools, including CT angiography and angiopulmonography, as well as challenges of evaluating the operability of patients and the technical complexity of operations, patients with CTEPH are get together in the so-called reference centers. Within the framework of the CTEPH team concept, specific protocols and «road maps» have been developed for both diagnosis and treatment of the disease. In order to eliminate subjectivity in determining the operability of a patient with CTEPH, a special algorithm has been developed, which is applied to a clinical case for illustration. Monitoring patients with pulmonary embolism who are qualifed for a newly coined definition – postembolic pulmonary syndrome, has become a new task of the reference centers. The new syndrome is suggested to include CTEPH, as well as a similar, but not identical pathological condition, named chronic thromboembolic lung disease. The treatment of choice for CTEPH is pulmonary thrombendarterectomy. Mandatory elements of the surgical protocol include the creation of a «dry» operating field by means of a temporary circulatory arrest under deep hypothermia of 18 °C. Operations for distal lesions of the pulmonary arteries have become a recent achievement. The success of the operation depends on the anatomical type of the lesions, the degree of distal arteriopathy, the extent of the intervention, and the comorbid factors. Immediate and long-term results of the operation are evaluated as good and very good. The long-term survival of patients after surgery is significantly higher than of those who were administered medical treatment.Conclusions. Patients with suspected CTEPH should be referred to a reference expert center for diagnosis verification and operability determining. The standard diagnosis of CTEPH is angiopulmonography with simultaneous measurement of pressure in the right heart; the standard treatment is pulmonary thrombendarterectomy.

scholarly journals Surgical Treatment of Chronic Thromboembolic Pulmonary Hypertension

2007 ◽  
Vol 6 (2) ◽  
pp. 83-91
Author(s):  
Michael M. Madani ◽  
Stuart W. Jamieson
Keyword(s):  
Pulmonary Hypertension ◽  
Medical Management ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Thromboembolic Disease ◽  
Definitive Treatment ◽  
Pulmonary Vasculature ◽  
Pulmonary Thromboendarterectomy ◽  
Thromboembolic Pulmonary Hypertension ◽  
Long Term Prognosis

Pulmonary hypertension as the result of chronic pulmonary thromboembolic disease is a serious condition with poor long-term prognosis. The condition is one of the more common cardiovascular diseases affecting Americans, yet it is severely underdiagnosed. Pulmonary thromboendarterectomy is the definitive treatment for chronic pulmonary hyper-tension as the result of thromboembolic disease; however. it is an uncommon procedure, primarily because of lack of recognition on the part of the clinicians. Patients affected by chronic thromboembolic pulmonary hypertension (CTEPH) may present with a variety of debilitating cardiopulmonary symptoms. However, once diagnosed, there is no curative role for medical management, and surgery remains the only option. Palliation therapy with medical management in order to delay surgery carries the risk of prolonging the disease and irreversibly damaging unaffected pulmonary vasculature.

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