Management of cardiac dysfunction in neonates with pulmonary hypertension and the role of the ductus arteriosus

J L Ruoss; S Cavallaro Moronta; C Bazacliu; R E Giesinger; P J McNamara

doi:10.1016/j.siny.2022.101368

Management of cardiac dysfunction in neonates with pulmonary hypertension and the role of the ductus arteriosus

Semin Fetal Neonatal Med. 2022 Aug;27(4):101368. doi: 10.1016/j.siny.2022.101368. Epub 2022 Jun 11.

Authors

J L Ruoss¹, S Cavallaro Moronta², C Bazacliu¹, R E Giesinger², P J McNamara³

Affiliations

¹ Division of Neonatology, Department of Pediatrics, University of Florida, USA.
² Division of Neonatology, Department of Pediatrics, University of Iowa, USA.
³ Division of Neonatology, Department of Pediatrics, University of Iowa, USA. Electronic address: patrick-mcnamara@uiowa.edu.

PMID: 35798649
DOI: 10.1016/j.siny.2022.101368

Abstract

Pulmonary hypertension in the neonate is associated with cardiopulmonary disturbances and neurodevelopment morbidity. The patent ductus arteriosus is a persistent fetal shunt that can be pathologic vs supportive in the setting of neonatal pulmonary hypertension. Understanding the underlying pathophysiology of pulmonary hypertension and the cardiopulmonary effects of various phenotypes can guide management in this vulnerable population. In this narrative, we will summarize the physiologic principles of pulmonary hypertension, the impact of the patent ductus arteriosus on various phenotypes, and the utility of serial targeted neonatal echocardiography to individualize clinical assessment and management.

Keywords: Patent ductus arteriosus; Pulmonary hypertension; Targeted neonatal echocardiography; Ventricular function.

Publication types

Review

MeSH terms

Ductus Arteriosus*
Ductus Arteriosus, Patent* / complications
Ductus Arteriosus, Patent* / therapy
Echocardiography
Humans
Hypertension, Pulmonary* / etiology
Hypertension, Pulmonary* / therapy