Persistent Pulmonary Hypertension of the Newborn(PPHN)

Posted by e-Medical PPT Wednesday, July 11, 2012
Transitional Physiology
The process of postnatal circulatory
adjustments made by the newborn
It is the most dramatic event in human physiology
Converts high PVR to low PVR of the postnatal lung
8-10 fold increase in pulmonary blood flow

Events Critical to Postnatal Circulation
Ventilation
Oxygenation
Cord clamping

Ventilation
Clears fetal lung fluid
Establishes functional residual capacity
Creates a fluid-gas interface w/in the alveolus
Reduces pressure on pulmonary capillary beds
Stimulates surfactant production
Increases pulmonary blood flow
Increases pulmonary venous return
Increases left ventricular output
Increases oxygen tension
Stimulates pulmonary stretch receptors
Produces reflex vasodilatation of the peripheral vascular beds..

Epidemiology
Persistent Pulmonary Hypertension of the Newborn occurs in 2-6/1000 live births
Accounts for up to 10% of NICU admissions
PPHN carries a mortality rate of 11%
Results in > 900 deaths each year
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