High-Frequency Oscillatory Ventilation Augments the Response to Inhaled Nitric Oxide in Persistent Pulmonary Hypertension of the Newborn

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    2018, Pediatrics and Neonatology
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    HFV in combination with iNO results in the greatest improvement in oxygenation in some newborns who have severe PPHN complicated by diffuse parenchymal lung disease and underinflation.17 Infants with RDS and MAS benefit most from a combination of HFV and iNO therapy.14,15,18,19 For infants without associated lung disease, hypoxemia is caused by right-to-left shunting rather than by ventilation-perfusion imbalance.

  • Update on PPHN: Mechanisms and treatment

    2014, Seminars in Perinatology
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    HFV in combination with iNO resulted in the greatest improvement in oxygenation in some newborns who had severe PPHN complicated by diffuse parenchymal lung disease and underinflation.74 Infants with RDS and MAS benefit most from a combination of HFV and iNO therapy.75,76 “Gentle” ventilation strategies with optimal PEEP, relatively low PIP and some permissive hypercapnia are now being recommended to ensure adequate lung expansion without causing barotrauma.

  • The pulmonary circulation in neonatal respiratory failure

    2012, Clinics in Perinatology
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    A randomized controlled trial showed that treatment with HFOV and iNO was often successful in patients who failed to respond to HFOV or iNO alone in severe PPHN, and the differences in responses were related to the specific disease associated with PPHN. Infants with RDS and MAS benefit most from a combination of HFOV and iNO therapy.88,89 Oxygen is a specific and potent pulmonary vasodilator and increased oxygen tension is an important mediator of reduction in PVR at birth.

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