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[PMID]:28658134
[Au] Autor:Park BY; Chung SH
[Ad] Endereço:Department of Pediatrics, Kyung Hee University School of Medicine, Seoul, Korea.
[Ti] Título:Treprostinil for persistent pulmonary hypertension of the newborn, with early onset sepsis in preterm infant: 2 Case reports.
[So] Source:Medicine (Baltimore);96(26):e7303, 2017 Jun.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Persistent pulmonary hypertension of the newborn (PPHN) is a syndrome of failed circulatory adaptation at birth with persisting increased pulmonary vascular resistance that is associated with high mortality rates especially in preterm infants. PATIENT CONCERNS: We reported 2 cases of PPHN in preterm infants with respiratory distress syndrome and early onset sepsis refractory to therapy with vasopressors, inotropes, and inhaled nitric oxide (iNO), in whom treatment with treprostinil was successful. DIAGNOSES: Infants showed a difference of more than 10% between pre- and postductal saturation of peripheral oxygen by pulse oximetry. Echocardiogram showed flattened ventricular septum, right to left shunting through the patent ductus arteriosus, and tricuspid regurgitation velocity above 2.9 m/s. INTERVENTIONS: The patients received treprostinil through central venous line because iNO therapy was not effective. OUTCOMES: Within 6 to 12 hours after treatment with treprostinil, the patients showed dramatic clinical improvement, and no systemic side effects were observed, including intraventricular hemorrhage (≥grade II). LESSONS: IV treprostinil might be given to preterm infants with severe PPHN, who did not respond to conservative therapies, including iNO.
[Mh] Termos MeSH primário: Anti-Hipertensivos/administração & dosagem
Epoprostenol/análogos & derivados
Recém-Nascido Prematuro
Síndrome da Persistência do Padrão de Circulação Fetal/complicações
Síndrome da Persistência do Padrão de Circulação Fetal/tratamento farmacológico
Sepse/complicações
[Mh] Termos MeSH secundário: Administração Intravenosa
Resistência a Medicamentos
Epoprostenol/administração & dosagem
Seres Humanos
Recém-Nascido
Masculino
Sepse/tratamento farmacológico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antihypertensive Agents); DCR9Z582X0 (Epoprostenol); RUM6K67ESG (treprostinil)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170629
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007303


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[PMID]:28332379
[Au] Autor:Ma Y; Jang MA; Yoo HS; Ahn SY; Sung SI; Chang YS; Ki CS; Park WS
[Ad] Endereço:Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
[Ti] Título:A Novel De Novo Pathogenic Variant in FOXF1 in a Newborn with Alveolar Capillary Dysplasia with Misalignment of Pulmonary Veins.
[So] Source:Yonsei Med J;58(3):672-675, 2017 May.
[Is] ISSN:1976-2437
[Cp] País de publicação:Korea (South)
[La] Idioma:eng
[Ab] Resumo:Alveolar capillary dysplasia with misalignment of pulmonary veins (ACD/MPV) is an autosomal dominant, fatal developmental disorder of the lungs, with a mortality rate of about 100%. ACD/MPV is caused by mutations in FOXF1. Herein, we describe a newborn boy with ACD/MPV carrying a novel pathogenic variant of FOXF1. The patient developed respiratory distress and severe pulmonary hypertension on the first day of life. Despite aggressive cardiorespiratory management, including veno-venous extracorporeal membrane oxygenation, his condition deteriorated rapidly, and he died within the first month of his life. Lung histology showed the characteristic features of ACD/MPV at autopsy. Sequence analysis of FOXF1 from genomic DNA obtained from autopsied lung tissue revealed that the patient was heterozygous for a novel missense variant (c.305T>C; p.Leu102Pro). Further analysis of both parents confirmed the de novo occurrence of the variant. To the best of our knowledge, this is the first report of genetically confirmed ACD/MPV in Korea.
[Mh] Termos MeSH primário: Fatores de Transcrição Forkhead/genética
Pulmão/patologia
Mutação de Sentido Incorreto/genética
Síndrome da Persistência do Padrão de Circulação Fetal/genética
Alvéolos Pulmonares/anormalidades
Veias Pulmonares/anormalidades
[Mh] Termos MeSH secundário: Análise Mutacional de DNA
Predisposição Genética para Doença
Heterozigoto
Seres Humanos
Recém-Nascido
Masculino
Mutação
Síndrome da Persistência do Padrão de Circulação Fetal/diagnóstico
Síndrome da Persistência do Padrão de Circulação Fetal/terapia
República da Coreia
Análise de Sequência
[Pt] Tipo de publicação:CASE REPORTS
[Nm] Nome de substância:
0 (Forkhead Transcription Factors)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170501
[Lr] Data última revisão:
170501
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170324
[St] Status:MEDLINE
[do] DOI:10.3349/ymj.2017.58.3.672


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[PMID]:28316463
[Au] Autor:Castro EC; Sen P; Parks WT; Langston C; Galambos C
[Ad] Endereço:Department of Pathology & Immunology, Texas Children's Hospital, Baylor College of Medicine, 6621 Fannin St. MC-1195, Houston, TX 77030, USA.
[Ti] Título:The Role of Serotonin Transporter in Human Lung Development and in Neonatal Lung Disorders.
[So] Source:Can Respir J;2017:9064046, 2017.
[Is] ISSN:1916-7245
[Cp] País de publicação:Egypt
[La] Idioma:eng
[Ab] Resumo:Failure of the vascular pulmonary remodeling at birth often manifests as pulmonary hypertension (PHT) and is associated with a variety of neonatal lung disorders including a uniformly fatal developmental disorder known as alveolar capillary dysplasia with misalignment of pulmonary veins (ACD/MPV). Serum serotonin regulation has been linked to pulmonary vascular function and disease, and serotonin transporter (SERT) is thought to be one of the key regulators in these processes. We sought to find evidence of a role that SERT plays in the neonatal respiratory adaptation process and in the pathomechanism of ACD/MPV. We used histology and immunohistochemistry to determine the timetable of SERT protein expression in normal human fetal and postnatal lungs and in cases of newborn and childhood PHT of varied etiology. In addition, we tested for a SERT gene promoter defect in ACD/MPV patients. We found that SERT protein expression begins at 30 weeks of gestation, increases to term, and stays high postnatally. ACD/MPV patients had diminished SERT expression without SERT promoter alteration. We concluded that SERT/serotonin pathway is crucial in the process of pulmonary vascular remodeling/adaptation at birth and plays a key role in the pathobiology of ACD/MPV.
[Mh] Termos MeSH primário: Pulmão/metabolismo
Síndrome da Persistência do Padrão de Circulação Fetal/etiologia
Proteínas da Membrana Plasmática de Transporte de Serotonina/metabolismo
[Mh] Termos MeSH secundário: Adaptação Fisiológica
Feminino
Seres Humanos
Lactente
Recém-Nascido
Pulmão/embriologia
Masculino
Síndrome da Persistência do Padrão de Circulação Fetal/metabolismo
Regiões Promotoras Genéticas
Serotonina/metabolismo
Proteínas da Membrana Plasmática de Transporte de Serotonina/genética
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Serotonin Plasma Membrane Transport Proteins); 333DO1RDJY (Serotonin)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170927
[Lr] Data última revisão:
170927
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170321
[St] Status:MEDLINE
[do] DOI:10.1155/2017/9064046


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[PMID]:28202122
[Au] Autor:Wang MM; Li H; Zhang FF; Ma KT; Cao WW; Gu Q
[Ad] Endereço:Department of Pediatrics, First Affiliated Hospital of Shihezi University, Shihezi, Xinjiang 832000, China. guqiang106@sina.com.
[Ti] Título:[Role of calcium-sensing receptor in neonatal mice with persistent pulmonary hypertension].
[So] Source:Zhongguo Dang Dai Er Ke Za Zhi;19(2):208-214, 2017 Feb.
[Is] ISSN:1008-8830
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:OBJECTIVE: To study the effect of calcium-sensing receptor (CaSR) agonists and antagonists on the expression of CaSR in neonatal mice with persistent pulmonary hypertension (PPHN), and to clarify the role of CaSR in neonatal mice with PPHN. METHODS: Forty-nine neonatal mice were randomly divided into four groups: control (n=10), hypoxia (PPHN; n=11), agonist (n=13), and antagonist (n=15). The mice in the PPHN, agonist, and antagonist groups were exposed to an oxygen concentration of 12%, and those in the control group were exposed to the air. The mice in the agonist and antagonist groups were intraperitoneally injected with gadolinium chloride (16 mg/kg) and NPS2390 (1 mg/kg) respectively once daily. Those in the PPHN and the control groups were given normal saline daily. All the mice were treated for 14 consecutive days. Hematoxylin and eosin staining and immunohistochemistry were used to observe the changes in pulmonary vessels. Laser confocal microscopy was used to observe the site of CaSR expression and measure its content in lung tissues. qRT-PCR and Western blot were used to measure the mRNA and protein expression of CaSR in lung tissues. RESULTS: Compared with the control group, the PPHN group had significant increases in the pulmonary small artery wall thickness and the ratio of right to left ventricular wall thickness (P<0.05), which suggested that the model was successfully prepared. Compared with the control group, the PPHN group had a significant increase in the mRNA and protein expression of CaSR (P<0.05), and the agonist group had a significantly greater increase (P<0.05); the antagonist group had a significant reduction in the mRNA and protein expression of CaSR (P<0.05). CONCLUSIONS: CaSR may play an important role in the development of PPHN induced by hypoxia in neonatal mice.
[Mh] Termos MeSH primário: Síndrome da Persistência do Padrão de Circulação Fetal/etiologia
Receptores de Detecção de Cálcio/fisiologia
[Mh] Termos MeSH secundário: Animais
Hipóxia/complicações
Pulmão/patologia
Camundongos
Miocárdio/patologia
Síndrome da Persistência do Padrão de Circulação Fetal/patologia
Artéria Pulmonar/patologia
RNA Mensageiro/análise
Receptores de Detecção de Cálcio/análise
Receptores de Detecção de Cálcio/genética
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (RNA, Messenger); 0 (Receptors, Calcium-Sensing)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170726
[Lr] Data última revisão:
170726
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170217
[St] Status:MEDLINE


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[PMID]:27940508
[Au] Autor:Steurer MA; Jelliffe-Pawlowski LL; Baer RJ; Partridge JC; Rogers EE; Keller RL
[Ad] Endereço:Departments of Pediatrics and steurermullerm@peds.ucsf.edu.
[Ti] Título:Persistent Pulmonary Hypertension of the Newborn in Late Preterm and Term Infants in California.
[So] Source:Pediatrics;139(1), 2017 Jan.
[Is] ISSN:1098-4275
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND OBJECTIVES: There are limited epidemiologic data on persistent pulmonary hypertension of the newborn (PPHN). We sought to describe the incidence and 1-year mortality of PPHN by its underlying cause, and to identify risk factors for PPHN in a contemporary population-based dataset. METHODS: The California Office of Statewide Health Planning and Development maintains a database linking maternal and infant hospital discharges, readmissions, and birth and death certificates from 1 year before to 1 year after birth. We searched the database (2007-2011) for cases of PPHN (identified by International Classification of Diseases, Ninth Revision codes), including infants ≥34 weeks' gestational age without congenital heart disease. Multivariate Poisson regression was used to identify risk factors associated with PPHN; results are presented as risk ratios, 95% confidence intervals. RESULTS: Incidence of PPHN was 0.18% (3277 cases/1 781 156 live births). Infection was the most common cause (30.0%). One-year mortality was 7.6%; infants with congenital anomalies of the respiratory tract had the highest mortality (32.0%). Risk factors independently associated with PPHN included gestational age <37 weeks, black race, large and small for gestational age, maternal preexisting and gestational diabetes, obesity, and advanced age. Female sex, Hispanic ethnicity, and multiple gestation were protective against PPHN. CONCLUSIONS: This risk factor profile will aid clinicians identifying infants at increased risk for PPHN, as they are at greater risk for rapid clinical deterioration.
[Mh] Termos MeSH primário: Idade Gestacional
Síndrome da Persistência do Padrão de Circulação Fetal/diagnóstico
Síndrome da Persistência do Padrão de Circulação Fetal/epidemiologia
[Mh] Termos MeSH secundário: California
Estudos de Coortes
Estudos Transversais
Bases de Dados Factuais
Feminino
Registros Hospitalares
Seres Humanos
Incidência
Recém-Nascido
Masculino
Síndrome da Persistência do Padrão de Circulação Fetal/etiologia
Síndrome da Persistência do Padrão de Circulação Fetal/mortalidade
Fatores de Risco
Taxa de Sobrevida
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170626
[Lr] Data última revisão:
170626
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161213
[St] Status:MEDLINE


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[PMID]:27894766
[Au] Autor:Houmes RJ; Ten Kate CA; Wildschut ED; Verdijk RM; Wijnen RM; de Blaauw I; Tibboel D; van Heijst AF
[Ad] Endereço:Intensive Care and Department of Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands. Electronic address: r.houmes@erasmusmc.nl.
[Ti] Título:Risk and relevance of open lung biopsy in pediatric ECMO patients: the Dutch experience.
[So] Source:J Pediatr Surg;52(3):405-409, 2017 Mar.
[Is] ISSN:1531-5037
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Open lung biopsy can help differentiate between reversible and irreversible lung disease and may guide therapy. To assess the risk-benefit ratio of this procedure in pediatric extracorporeal membrane oxygenation (ECMO) patients, we reviewed data of all patients who underwent an open lung biopsy during ECMO in one of the two pediatric ECMO centers in a nationwide study in the Netherlands. RESULTS: In nineteen neonatal and six pediatric patients (0-15.5years), twenty-five open lung biopsies were performed during the study period. In 13 patients (52%), a classifying diagnosis of underlying lung disease could be made. In another nine patients (36%), specific pathological abnormalities were described. In three patients (12%), only nonspecific abnormalities were described. The histological results led to withdrawal of ECMO treatment in 6 neonates with alveolar capillary dysplasia/misalignment of pulmonary veins (24%) and in another 6 patients, corticosteroids were started (24%). All patients survived the biopsy procedure. Hemorrhagic complications were rare. CONCLUSION: An open lung biopsy during an ECMO run in neonates and children is a safe procedure with a minimum risk for blood loss and biopsy-related death. It can be very useful in diagnosing the underlying pathology and can guide cessation of ECMO treatment and thereby avoid continuation of futile treatment, especially in neonatal patients. LEVEL OF EVIDENCE: III. TYPE OF STUDY: Diagnostic study.
[Mh] Termos MeSH primário: Biópsia/efeitos adversos
Oxigenação por Membrana Extracorpórea
Pneumopatias/patologia
Pulmão/patologia
[Mh] Termos MeSH secundário: Adolescente
Biópsia/métodos
Biópsia/mortalidade
Criança
Pré-Escolar
Feminino
Hemorragia/etiologia
Seres Humanos
Lactente
Recém-Nascido
Doenças do Recém-Nascido/patologia
Pneumopatias/etiologia
Masculino
Países Baixos
Síndrome da Persistência do Padrão de Circulação Fetal/patologia
Alvéolos Pulmonares/anormalidades
Alvéolos Pulmonares/patologia
Veias Pulmonares/anormalidades
Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170515
[Lr] Data última revisão:
170515
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161130
[St] Status:MEDLINE


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[PMID]:28446408
[Au] Autor:Li N; Chen HW; Zhou XH; Liang L
[Ad] Endereço:1Department of Neonatal Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China; 3Department of Neonatal Medicine, Children's Hospital of Dongguan, Dongguan 523325, China. E-mail: 529822789@qq.com.
[Ti] Título:[Clinicopathological analysis of pulmonary vascular disease in 38 neonates died of respiratory failure].
[So] Source:Nan Fang Yi Ke Da Xue Xue Bao;37(4):528-532, 2016 Apr 20.
[Is] ISSN:1673-4254
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:OBJECTIVE: We reviewed the data of 38 neonates who died of respiratory failure. Paraffin sections of the autopsy lung samples were examined with HE staining or immunolabeling for CD34, CD68 and CK to observe the development of the pulmonary vessels and detect potential pulmonary vascular diseases (PVDs). Five cases were identified to have PVDs, including pulmonary hypertensive vascular remodeling in 3 cases and alveolar capillary dysplasia in 2 cases. The result indicated that PVD was one of the important reasons for respiratory failure in these neonates.
[Mh] Termos MeSH primário: Pneumopatias/diagnóstico
Insuficiência Respiratória/mortalidade
Doenças Vasculares/diagnóstico
[Mh] Termos MeSH secundário: Morte
Seres Humanos
Recém-Nascido
Pulmão/patologia
Síndrome da Persistência do Padrão de Circulação Fetal/patologia
Alvéolos Pulmonares/anormalidades
Alvéolos Pulmonares/patologia
Remodelação Vascular
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171019
[Lr] Data última revisão:
171019
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170428
[St] Status:MEDLINE


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[PMID]:27822317
[Au] Autor:Szafranski P; Herrera C; Proe LA; Coffman B; Kearney DL; Popek E; Stankiewicz P
[Ad] Endereço:Department of Molecular and Human Genetics, Baylor College of Medicine, One Baylor Plaza, ABBR R809, Houston, TX 77030 USA.
[Ti] Título:Narrowing the distant enhancer region on 16q24.1 critical for ACDMPV.
[So] Source:Clin Epigenetics;8:112, 2016.
[Is] ISSN:1868-7083
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Alveolar capillary dysplasia with misalignment of pulmonary veins (ACDMPV) is a rare lethal lung developmental disorder caused by heterozygous point mutations or genomic deletions involving or its 60-kb tissue-specific enhancer region mapping 270 kb upstream of and involving fetal lung-expressed long non-coding RNA genes and CpG-enriched sites. Recently, we have proposed that the locus at 16q24.1 may be a subject of genomic imprinting. FINDINGS: Using custom-designed aCGH and Sanger sequencing, we have identified a novel de novo 104 kb genomic deletion upstream of in a patient with histopathologically verified full phenotype of ACDMPV. This deletion allowed us to further narrow the enhancer region and identify its critical 15-kb core interval, essential for lung development. This interval harbors binding sites for lung-expressed transcription factors, including GATA3, ESR1, and YY1, and is flanked by the lncRNA genes and CpG islands. Bisulfite sequencing of one of these CpG islands on the non-deleted allele showed that it is predominantly methylated on the maternal chromosome 16. CONCLUSIONS: Substantial narrowing and bisulfite sequencing of the enhancer region on 16q24.1 provided new insights into its regulatory function and genomic imprinting.
[Mh] Termos MeSH primário: Cromossomos Humanos Par 16/genética
Elementos Facilitadores Genéticos
Fatores de Transcrição Forkhead/genética
Síndrome da Persistência do Padrão de Circulação Fetal/genética
RNA Longo não Codificante/genética
Deleção de Sequência
[Mh] Termos MeSH secundário: Sítios de Ligação
Hibridização Genômica Comparativa
Ilhas de CpG
Receptor alfa de Estrogênio/genética
Feminino
Fatores de Transcrição Forkhead/química
Fator de Transcrição GATA3/genética
Impressão Genômica
Seres Humanos
Recém-Nascido
Masculino
Análise de Sequência de DNA/métodos
Fator de Transcrição YY1/genética
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Nm] Nome de substância:
0 (Estrogen Receptor alpha); 0 (FOXF1 protein, human); 0 (Forkhead Transcription Factors); 0 (GATA3 Transcription Factor); 0 (GATA3 protein, human); 0 (RNA, Long Noncoding); 0 (YY1 Transcription Factor); 0 (YY1 protein, human); 0 (estrogen receptor alpha, human)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170428
[Lr] Data última revisão:
170428
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161109
[St] Status:MEDLINE


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[PMID]:27589551
[Au] Autor:Nakwan N; Chaiwiriyawong P
[Ti] Título:An international survey on persistent pulmonary hypertension of the newborn: A need for an evidence-based management.
[So] Source:J Neonatal Perinatal Med;9(3):243-50, 2016 Sep 16.
[Is] ISSN:1878-4429
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To assess the current practice preferences in diagnosis and management of persistent hypertension of the newborn (PPHN) of neonatologists or pediatricians with expertise in neonatal care. STUDY DESIGN: Investigators identified potential participants worldwide through a literature search. They were emailed the URL of an online 25-item questionnaire through the web survey site SurveyMonkey®. Additional respondents were also acquired through a professional online discussion group. The survey was conducted during July - September 2015. RESULTS: Overall, there were 200 respondents from 51 different countries. Of these, the average 2014 mortality rate of the 90 respondents who completed this section of the questionnaire was 8.3% (interquartile range (IQR): 0-20.3). Echocardiography together with pre-to-post ductal oxygen pulse oximetry (SpO2) gradient was the most common PPHN diagnostic method. The most frequent first-line pulmonary vasodilator was inhaled nitric oxide (155/199, 77.9%). Oral sildenafil was most commonly used as second-line adjunctive therapy by 46.3% (81/175). Dopamine (139/198, 70.2%) was chosen to be the initial inotropic agent and normal saline (191/199, 96.0%) was the preferred initial fluid resuscitation for hypotension. Sedation and analgesia were routinely used for PPHN treatment. Twenty-one percent (42/199) of respondents also used muscle relaxants to control respiratory distress. The most commonly used targets for partial pressure of oxygen, partial pressure of carbon dioxide, SpO2 and hemoglobin were 71-80 mmHg (60/197, 30.4%), 36-45 mmHg (100/199, 50.2%), 91-95% (111/199, 55.8%), and 13-15 gm/dL (156/196, 79.6%), respectively. CONCLUSIONS: This survey shows that the management of PPHN varies widely around the world. The major PPHN diagnostic method is echocardiography together with bedside SpO2 monitoring. The study numbers show the main differences are between developed and developing countries. Further studies exploring evidence-based principles of diagnosis and management in PPHN are warranted.
[Mh] Termos MeSH primário: Prática Clínica Baseada em Evidências
Pesquisas sobre Serviços de Saúde
Internacionalidade
Síndrome da Persistência do Padrão de Circulação Fetal/diagnóstico
Síndrome da Persistência do Padrão de Circulação Fetal/terapia
Padrões de Prática Médica/estatística & dados numéricos
[Mh] Termos MeSH secundário: Países Desenvolvidos
Países em Desenvolvimento
Ecocardiografia
Feminino
Seres Humanos
Recém-Nascido
Masculino
Neonatologia/organização & administração
Neonatologia/tendências
Sistemas Automatizados de Assistência Junto ao Leito
Vasodilatadores/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Vasodilator Agents)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170823
[Lr] Data última revisão:
170823
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160903
[St] Status:MEDLINE
[do] DOI:10.3233/NPM-16915133


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[PMID]:27589542
[Au] Autor:Al Omar S; Salama H; Al Hail M; Al Rifai H; Bunahia M; El Kasem W; Siddiqui FJ; Dilawar M; Yassin H; Masud F; Mohamed A; Mansour A
[Ti] Título:Effect of early adjunctive use of oral sildenafil and inhaled nitric oxide on the outcome of pulmonary hypertension in newborn infants. A feasibility study.
[So] Source:J Neonatal Perinatal Med;9(3):251-9, 2016 Sep 16.
[Is] ISSN:1878-4429
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Inhaled nitric oxide (iNO) is the standard therapy for infants with persistent pulmonary hypertension of the newborn (PPHN). Recently, sildenafil has been evaluated as an alternative or adjunctive pulmonary vasodilator. OBJECTIVE: To assess the effectiveness of adding sildenafil as an early adjunctive therapy together with iNO when treating newborns with PPHN and/or hypoxemic respiratory failure. METHODS: This is a randomized placebo trial on newborns with gestational age > 34 weeks, postnatal age < 48 hours, and diagnosed with PPHN (oxygen index (OI) ≥ 20). Newborns were randomized to two groups: Group A- received oral sildenafil and iNO, and group B- received placebo and iNO. Initial and follow up echocardiography were performed over 14 days period. RESULTS: A total of 24 newborns were recruited; 13 of them received sildenafil in addition to iNO and 11 received iNO and placebo. The most common causes of PPHN were meconium aspiration syndrome, pneumonia, and RDS. At the starting point, OI was marginally higher in the intervention group without statistical significance (29 vs 28). There were no differences between the two groups regarding surfactant administration, incidence of pneumothoraces, and the underlying causes of PPHN. Sildenafil or placebo treatment started within 12 hours after starting iNO (8 vs 6 hours). CONCLUSION: Early use of oral sildenafil next to iNO in cases of PPHN was tolerated well by newborns and it did not show significant adverse effects. Further studies with a larger sample size is needed to assess its effecacy.
[Mh] Termos MeSH primário: Óxido Nítrico/administração & dosagem
Óxido Nítrico/uso terapêutico
Síndrome da Persistência do Padrão de Circulação Fetal/tratamento farmacológico
Citrato de Sildenafila/administração & dosagem
Citrato de Sildenafila/uso terapêutico
Vasodilatadores/administração & dosagem
Vasodilatadores/uso terapêutico
[Mh] Termos MeSH secundário: Administração Oral
Método Duplo-Cego
Estudos de Viabilidade
Feminino
Seres Humanos
Recém-Nascido
Recém-Nascido Prematuro
Masculino
Nebulizadores e Vaporizadores
Síndrome da Persistência do Padrão de Circulação Fetal/fisiopatologia
Estudos Prospectivos
Catar/epidemiologia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Vasodilator Agents); 31C4KY9ESH (Nitric Oxide); BW9B0ZE037 (Sildenafil Citrate)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170823
[Lr] Data última revisão:
170823
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160903
[St] Status:MEDLINE
[do] DOI:10.3233/NPM-16161



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