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Pulmonary Hypertension in Infants

written by: R. Elizabeth C. Kitchen • edited by: Diana Cooper • updated: 8/30/2010

Do you suspect your infant could have pulmonary hypertension? If so, read on to learn more about infant pulmonary hypertension.

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    Infant pulmonary hypertension, most often referred to as persistent pulmonary hypertension of the newborn, can result in long-term complications and have serious effects on an infant's health, but it is not common. This condition is characterized by the pulmonary artery sending, through the ductus arteriosus, blood back to the heart. Approximately 1 in 700 births experience this condition.

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    Signs and Symptoms

    Infants with this condition often exhibit certain signs and symptoms. These can include:

    • Rapid breathing
    • Respiratory distress
    • Rapid heart rate
    • Skin having a bluish tint

    Some infants will also have a heart murmur.

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    How is this Condition Diagnosed?

    Any infant that is showing signs of having trouble breathing should be evaluated for infant pulmonary hypertension. Diagnostic imaging testing is commonly done to help diagnose this condition. Such tests include:

    • An echocardiogram (ultrasound of the heart) can help to show if the infant has a lung or heart disease, and can see the direction of blood flow in the lungs and heart. This can determine if this condition does exist.
    • A chest x-ray can be done to determine whether the infant has an enlarged heart or a lung disease.
    • A head ultrasound can be done to determine if the infant has any bleeding in their brain.

    Laboratory tests are also often performed to help the doctor make a diagnosis. Such tests include:

    • A complete blood count to examine how many white blood cells, red blood cells, and platelets an infant has.
    • A lumbar puncture to look for an infection.
    • A arterial blood gas test to determine how much carbon dioxide, oxygen, and acid buildup is present in the infant's arterial blood.
    • A serum electrolyte test can help to see how well the minerals are balanced in the blood.
    • A pulse oximetry will measure how much oxygen is in the blood.
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    Treatment Methods

    A neonatologist, a doctor specializing in newborn health and medical problems, will determine and direct the infant's treatment for this condition. Infants will be placed in a neonatal intensive care unit for their treatment. Giving the infant 100 percent oxygen is the first step to help bring their oxygen levels back to normal. A ventilator is used to do this.

    Nitric oxide may be given to the infant to help improve lung blood flow. An extracorporeal membrane oxygenation (ECMO) could be necessary for infants who are not responding to other treatments. This procedure requires the infant to undergo major surgery, has possible side effects that are serious, and is complicated to monitor. This machine will take the place of the lungs and heart for several days so that the infant's lungs can heal and recover. This treatment has a very high success rate, but less than 100 United States hospitals offer this treatment.

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    Resources

    The Children's Hospital. (2001). Persistent Pulmonary Hypertension of the Newborn (PPHN). Retrieved on August 25, 2010 from The Children's Hospital: http://www.thechildrenshospital.org/wellness/info/parents/20830.aspx

    Merck. (2009). Persistent Pulmonary Hypertension of the Newborn. Retrieved on August 25, 2010 from Merck: http://www.merck.com/mmpe/sec19/ch277/ch277f.html