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Therapy of pulmonary hypertension in neonates and infants

Thomas Hoehn1

  • 1Neonatology and Pediatric Intensive Care Medicine, Department of General Pediatrics, Heinrich-Heine-University, Moorenstr. 5 D-40225 Duesseldorf, Germany. thomas.hoehn@uni-duesseldorf.de

Pharmacology & Therapeutics
|May 22, 2007
PubMed

Insights

This review summarizes pulmonary hypertension (PH) in infants, covering its causes, diagnosis, and treatments. It highlights adult therapies like endothelin receptor antagonists (ETRA) and phosphodiesterase (PDE) inhibitors, stressing the need for infant trials.

Area of Science:

  • Pediatric Cardiology
  • Neonatology
  • Pulmonology

Background:

  • Pulmonary hypertension (PH) in infants can be idiopathic or secondary to various pulmonary or cardiovascular diseases.
  • Understanding the pathophysiology and structural changes in infant PH is crucial for effective management.

Purpose of the Study:

  • To review current knowledge on the pathophysiology, structural changes, diagnosis, and treatment of PH in infants (<1 year).
  • To discuss the potential application of adult PH therapies and novel pharmacotherapeutic agents in this age group.

Main Methods:

  • Comprehensive literature review of pathophysiology, diagnosis, and treatment of PH in infants.
  • Analysis of current and emerging pharmacotherapies, including those used in adults.

Main Results:

  • PH in infants presents diverse etiologies, often linked to pulmonary or cardiac conditions.
  • Adult treatments like endothelin receptor antagonists (ETRA) and phosphodiesterase (PDE) inhibitors show promise, but require infant-specific trials.
  • Emerging pharmacotherapies include vasoactive intestinal polypeptide (VIP), PDE-3/4 inhibitors, HMG-CoA reductase inhibitors, and adrenomedullin (ADM).

Conclusions:

  • Further randomized controlled trials are essential to establish the safety and efficacy of PH treatments in newborns and infants.
  • Novel therapeutic targets offer future potential for managing infant pulmonary hypertension.

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