Persistent Pulmonary Hypertension Of The Newborn

Yıl 2017, Cilt: 14 Sayı: 4, 182 - 186, 01.10.2017

Ufuk Çakır Cüneyt Tayman Mehmet Büyüktiryaki Halil İbrahim Yakut

Öz

Persistent pulmonary hypertension PPHT of the newborn which can be secondary or idiopathic in many cases is associated with morbidity and mortality. Inadequate of pulmonary relaxation after birth results in PPHT, and oxygen-free blood shunts from pulmonary to systemic circulation. Term and near term babies are affected more frequently. Regardless of etiology, short- and long-term morbidite-related hypoxemia should be avoided, and thus, after diagnosis, available treatment should promptly be started. Echocardiography is the main diagnostic method for the exclusion of structural heart diseases in diagnosis. The main treatments includes oxygen supplementation, mechanical ventilation, nitric oxide, phosphodiesterase inhibitors, prostaglandin analogues, endothelin receptor antagonists, and extracorporeal membrane oxygenation, as well as treatment of underlying disease. Optimal treatment approach is still controversial. Treatments applied in newborns with PPHT should guarantee chronic health problems after discharge and long term results, that will not cause neurodevelopmental deficit.

Anahtar Kelimeler

Persistant pulmonary hypertension, newborn, pulmonary vasodilator, nitric oxide, extracorporeal membrane oxygenation

Yenidoğanın Persistan Pulmoner Hipertansiyonu

Öz

Yenidoğanda persistan pulmoner hipertansiyon PPHT birçok duruma ikincil ya da idiyopatik olabilen morbidite ve mortaliteler ile ilişkili bir durumdur. PPHT doğumdan sonra pulmoner relaksasyonun yetersizliği ve oksijensiz kanın pulmonerden sistemik dolaşıma şantı ile sonuçlanır. Term ve terme yakım bebekleri daha sık etkiler. Etiyolojiye bakılmaksızın kısa ve uzun dönem morbiditelerle ilişkili hipoksemiden kaçınır kaçırmaz, tanı konup tedavi edilmelidir. Tanıda yapısal kalp hastalıklarının dışlanması için ekokardiyografi EKO başlıca tanı yöntemidir. Başlıca tedavi, altta yatan hatsalığın tedavisi ile birlikte oksijen desteği, mekanik ventilasyon, nitrik oksit, fosfodiesteraz inhibitörleri, prostaglandin analogları, endotelin reseptör antagonistleri ve ekstrakorporyal membran oksijenizasyonu gibi umut verici tedaviler vardır. Optimal tedavi yaklaşımı tartışmalıdır. PPHT olan yenidoğanlarda uygulanan tedaviler, taburculuk sonrası kronik sağlık problemleri ve nörogelişimsel defisite yol açmayacak uzun dönem sonuçlarını garanti etmelidir.

Anahtar Kelimeler

Persistan pulmoner hipertansiyon, yenidoğan, pulmoner vazodilatör, nitrik oksit, ekstrakorporyal membran oksijenizasyonu

Kaynakça

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