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Updated: Mar 1, 2026

Induction and Phenotyping of Acute Right Heart Failure in a Large Animal Model of Chronic Thromboembolic Pulmonary Hypertension
Published on: March 17, 2022
Pulmonary hypertension and right heart failure due to severe hypernatremic dehydration
Saurabh Chiwane1, Tageldin M Ahmed1, Christian P Bauerfeld1
1Department of Pediatrics, Division of Critical Care, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI, USA.
Introduction:
Neonates are at risk of developing hypernatremic dehydration and its associated complications, such as stroke, dural sinus thrombosis and renal vein thrombosis. Pulmonary hypertension has not been described as a complication of hypernatremia.
Case Report:
We report a case of a seven-day-old neonate with severe hypernatremic dehydration who went on to develop pulmonary hypertension and right heart failure needing extracorporeal membrane oxygenation (ECMO).
Discussion:
Normal or high anion gap metabolic acidosis commonly accompanies hypernatremic dehydration. The presence of acidosis and/or hypoxia can delay the normal drop in pulmonary vascular resistance (PVR) after birth, causing pulmonary hypertension and right ventricular failure.
Conclusion:
A high index of suspicion is paramount to diagnose pulmonary hypertension and aggressive correction of the acidosis and hypoxia is needed. In the presence of severe right ventricular failure, ECMO can be used as a bridge to recovery while underlying metabolic derangements are being corrected.
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