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Pediatr Pulmonol. 2005 Jun;39(6):492-503.

Pathophysiologic mechanisms of persistent pulmonary hypertension of the newborn.

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  • Department of Pediatrics, University of Manitoba, Manitoba Institute of Child Health, Winnipeg, Canada. dakshina@cc.umanitoba.ca


Persistent pulmonary hypertension of the newborn (PPHN), among the most rapidly progressive and potentially fatal of vasculopathies, is a disorder of vascular transition from fetal to neonatal circulation, manifesting as hypoxemic respiratory failure. PPHN represents a common pathway of vascular injury activated by numerous perinatal stresses: hypoxia, hypoglycemia, cold stress, sepsis, and direct lung injury. As with other multifactorial diseases, a single inciting event may be augmented by multiple concurrent/subsequent phenomena that result in differing courses of disease progression. I review the various mechanisms of vascular injury involved in neonatal pulmonary hypertension: endothelial dysfunction, inflammation, hypoxia, and mechanical strain, in the context of downstream effects on pulmonary vascular endothelial-myocyte interactions and myocyte phenotypic plasticity.

Copyright 2005 Wiley-Liss, Inc.

[PubMed - indexed for MEDLINE]
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