Persistent pulmonary hypertension of the newborn (PPHN) is a serious medical condition that affects newborns and causes their blood pressure to be higher than normal. It is a life-threatening condition that can lead to respiratory failure, organ damage, and even death if not treated promptly.
Treatment for PPHN usually involves inhaled nitric oxide therapy, which helps to reduce the pressure in the lungs and improve oxygenation in the baby's body. Other treatments may include medications, mechanical ventilation, or even surgery. The goal of treatment is to reduce the risk of long-term complications associated with PPHN and ensure that the baby recovers fully.
Prevalence and risk factors- Persistent pulmonary hypertension of the newborn (PPHN) is a serious condition that affects newborns in India. It can cause severe breathing problems and even death. The prevalence of PPHN in India is increasing due to various risk factors such as maternal smoking, late preterm births, and low birth weight. Other causes include genetic factors, maternal infections, and exposure to certain medications or drugs during pregnancy.
Structural defect in PPHN- The structural defect in PPHN is caused by abnormal development of the fetal lungs and pulmonary circulation, resulting in an obstruction to the normal flow of blood from the right ventricle to the lungs. This obstruction can be due to several factors, including abnormal development of the pulmonary arteries or a narrowing or closure of them due to scarring or inflammation.
Inhaled nitric oxide (iNO) therapy is a promising treatment for persistent pulmonary hypertension of the newborn (PPHN). It is an effective way to reduce hypoxemia and improve oxygenation in newborns with PPHN. iNO works by releasing nitric oxide into the lungs, which helps relax the muscles of the pulmonary vasculature and reduce blood pressure in the lungs.
Inhaled nitric oxide has been used to treat PPHN in neonates since its introduction in 1994, and has been found to be safe and effective. Studies have shown that iNO can significantly improve oxygenation, reduce mortality rates, and improve clinical outcomes for newborns with PPHN.
Inhaled nitric oxide (iNO) therapy has been used to treat persistent pulmonary hypertension of the newborn (PPHN) since the 1990s. The use of iNO in neonates has grown steadily since then, as it is a safe and effective pulmonary vasodilator. It can also be used to close patent ductus arteriosus (PDA), and is well tolerated by newborns when inhaled.
(Patent ductus arteriosus (PDA) is a congenital heart defect in which the pulmonary artery and the aorta are connected by an abnormal vessel. This abnormality can cause serious complications such as heart failure, congestive heart failure or even death. Inhaled nitric oxide (iNO) therapy is one of the most common treatments for PDA. iNO therapy works by increasing oxygen levels in the blood and decreasing pulmonary pressure, thus helping to reduce symptoms associated with PDA.)
While iNO has been proven to be an effective treatment for PPHN, there are some risks associated with its use. These include potential adverse effects on blood pressure, oxygenation, and heart rate. In addition, there is a risk of infection due to the inhalation of NO gas in newborns.
In some cases, surgery is the only option to treat PPHN. Surgery involves connecting a tube between the baby’s right and left ventricles, allowing blood to flow more easily through the lungs.
The process of PPHN surgery is complex and requires expert medical care. During surgery, doctors will make an incision in the baby’s chest and insert a tube into their heart that connects their right and left ventricles. This helps increase blood flow to their lungs, which can reduce symptoms associated with PPHN. The procedure has several advantages, including improved oxygen levels in the body, improved breathing ability, reduced risk of long-term complications from PPHN, and better quality of life for infants who receive this treatment.
One more good news is that lifestyle changes can help improve outcomes for those suffering from PPHN. These changes include proper nutrition, exercise, avoiding smoking and alcohol, managing stress, sleeping well, and avoiding environmental toxins. Making these lifestyle changes can help reduce the risk of complications associated with PPHN and potentially improve overall health outcomes.
The role of family, hospitals and caregivers in managing PPHN is critical for successful outcomes. Families play an important role in providing emotional support to their baby during this difficult time. They should ensure that their baby receives the best possible care from the hospital or other healthcare providers.
Hospitals should be equipped with the right infrastructure and personnel to manage PPHN cases effectively and provide timely treatment to affected babies. Caregivers should be knowledgeable about PPHN and its management so that they can provide appropriate care for affected babies at home or in a healthcare setting. With proper support from family, hospitals and caregivers, PPHN can be successfully managed with positive outcomes for families and their newborns.
Nimai Institute of Medical Sciences Private Limited (NIMS) was founded by its founder chairman Dr Santosh N. Madrewar, a renowned Pediatrician, who has designed an unique Mother and Child Health Concept, integrating modern medical management with Ayurvedic treatments and traditional Indian ethos making Pregnancy and Birthing a Joyous Celebrations and Child development focused on Physical, Mental, Social and Spiritual Well-being.
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