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Related Concept Videos

Pulmonary Hypertension: Classification and Pathogenesis01:30

Pulmonary Hypertension: Classification and Pathogenesis

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Pulmonary hypertension (PH) is a severe health condition in which the mean pulmonary arterial pressure increases to 25 mmHg or more, even when the body is at rest. This high pressure in the blood vessels that transport blood from the heart to the lungs can cause various symptoms, including shortness of breath, can lead to right heart failure, and significantly affect the overall quality of life.
There are various classifications for PH, each relating to different underlying causes and also...
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Pulmonary Embolism I: Introduction01:29

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Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
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Pulmonary Cycle: Exhalation01:17

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In terms of human respiration, the act of expelling air, known as exhalation (or expiration), operates on the principle of pressure gradients. During expiration, the pressure within the lungs exceeds that of the surrounding atmosphere. Under normal conditions, quiet breathing involves passive exhalation and is free of muscular contractions. This is because the exhalation process is driven by the natural elastic recoil of the lungs and chest wall, both of which have an inherent tendency to...
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Treatment for Pulmonary Arterial Hypertension: Oxygen Therapy for Respiratory Failure01:16

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Oxygen therapy has emerged as a significant tool in enhancing the quality of life for patients suffering from pulmonary arterial hypertension (PAH). While this therapy has principally been studied on patients with significant hypoxemia, this therapeutic approach helps prevent potential organ damage and can be administered in the comfort of one's home.
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue,...
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Pulmonary Function Tests01:25

Pulmonary Function Tests

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Pulmonary Function Tests (PFTs)
Pulmonary Function Tests are crucial diagnostic tools for assessing respiratory function, particularly in patients with chronic respiratory disorders. They comprehensively evaluate lung volumes, ventilatory function, breathing mechanics, diffusion, and gas exchange. These tests help diagnose pulmonary diseases and play a significant role in monitoring disease progression, evaluating disability, and assessing response to therapy.
PFTs involve using a spirometer, a...
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Pneumothorax-I01:26

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A pneumothorax is a condition where air builds up in the space between the lung and the chest wall, causing the lung to collapse. This condition arises when air enters the space between the parietal and visceral pleura, disrupting the negative pressure essential for lung inflation. This can lead to a partial or complete collapse of the lung.
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
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Persistent Pulmonary Hypertension in the Newborn.

Bobby Mathew1, Satyan Lakshminrusimha2

  • 1Department of Pediatrics, University at Buffalo, Buffalo, NY 14222, USA. bmathew@upa.chob.edu.

Children (Basel, Switzerland)
|August 10, 2017
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Persistent pulmonary hypertension of the newborn (PPHN) is a circulatory adaptation failure at birth. Improved survival with treatments like inhaled nitric oxide (iNO) offers hope, but research continues for better outcomes.

Keywords:
hypoxemianitric oxideoxygenpulmonary blood flow

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Area of Science:

  • Neonatology
  • Pediatric Cardiology
  • Respiratory Physiology

Background:

  • Persistent pulmonary hypertension of the newborn (PPHN) arises from delayed circulatory adaptation post-birth.
  • Fetal circulation relies on placental oxygenation, with a physiological pulmonary hypertension.
  • Transition at birth involves a significant drop in pulmonary vascular resistance (PVR) and increased systemic vascular resistance (SVR).

Purpose of the Study:

  • To define PPHN as a failure of normal circulatory transition at birth.
  • To outline the pathophysiology of PPHN, including impaired PVR fall.
  • To discuss current and emerging therapeutic strategies for PPHN.

Main Methods:

  • The abstract describes the physiological transition from fetal to neonatal circulation.
  • It reviews the pathophysiology of PPHN resulting from failed adaptation.
  • It summarizes current and investigational treatments for PPHN.

Main Results:

  • PPHN presents as hypoxemic respiratory failure due to impaired pulmonary circulation.
  • Survival rates have improved with gentle ventilation, surfactant, and inhaled nitric oxide (iNO).
  • Significant mortality and morbidity persist in survivors.

Conclusions:

  • PPHN is a critical condition requiring prompt management.
  • Current treatments like iNO have improved outcomes, but long-term effects remain a concern.
  • Novel therapeutic agents targeting vascular smooth muscle pathways are under development to further reduce PPHN morbidity and mortality.