How is persistent pulmonary hypertension of the newborn (PPHN) defined?

Updated: Sep 03, 2019
  • Author: Kate A Tauber, MD; Chief Editor: Howard S Weber, MD, FSCAI  more...
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Persistent pulmonary hypertension of the newborn (PPHN) is defined as the failure of the normal circulatory transition that occurs after birth. It is a syndrome characterized by marked pulmonary hypertension that causes hypoxemia secondary to right-to-left extrapulmonary shunting of deoxygenated blood. Clinically, PPHN is most often recognized in term or near-term neonates, but it is being increasingly recognized in preterm infants as well. [4]

Because virtually all newborns are born with elevated pulmnary pressures and have a patent foramen ovale and a patent ductus arteriosus immediately after birth, the presence of elevated pulmonary vascular resistance beyond baseline (PPHN) may lead to a right-to-left shunting of blood and severe hypoxemia. With inadequate pulmonary perfusion, neonates are at risk for developing refractory hypoxemia, hypercarbia, and acidosis.

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