Embracing the challenges of neonatal and paediatric pulmonary hypertension

Area of Science:

• Pediatric Cardiology
• Pulmonology
• Critical Care Medicine

Background:

• Paediatric pulmonary arterial hypertension (PAH) shares traits with adult PAH but presents unique challenges.
• Associated disorders and specific patient populations necessitate distinct management strategies.

Purpose of the Study:

• To review recent advances, ongoing challenges, and distinct approaches in paediatric pulmonary hypertension (PH).
• To provide updates on diagnosis, classification, risk stratification, and treatment for paediatric PH.
• To identify critical knowledge gaps and propose solutions for paediatric PH management.

Main Methods:

• Consensus review by the paediatric task force of the 7th World Symposium on Pulmonary Hypertension.
• Inclusion of updated risk stratification tools and treatment algorithms.
• Discussion of novel strategies for PAH associated with congenital heart disease and neonatal PH.

Main Results:

• An updated risk stratification tool and treatment algorithm for paediatric PH, including strategies for associated cardiopulmonary conditions.
• Highlighting advances in diagnosing neonatal PH using echocardiography and emphasizing a team approach.
• Discussion of challenges in paediatric drug approval and clinical trial design.

Conclusions:

• Paediatric PH management requires tailored approaches, addressing specific patient populations and associated conditions.
• Despite advances, treatment remains hindered by a lack of robust clinical trials and challenges in drug development.
• A multimodal and team-based approach is crucial for optimizing outcomes in infants and children with PH.