Asphyxia, Therapeutic Hypothermia, and Pulmonary Hypertension

Regan Geisinger; Danielle R Rios; Patrick J McNamara; Philip T Levy

doi:10.1016/j.clp.2023.11.007

Asphyxia, Therapeutic Hypothermia, and Pulmonary Hypertension

Clin Perinatol. 2024 Mar;51(1):127-149. doi: 10.1016/j.clp.2023.11.007. Epub 2023 Dec 15.

Authors

Regan Geisinger¹, Danielle R Rios¹, Patrick J McNamara¹, Philip T Levy²

Affiliations

¹ Division of Neonatology, Department of Pediatrics, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA.
² Division of Newborn Medicine, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Hunnewell 436, Boston, MA 02115, USA. Electronic address: philip.levy@childrens.harvard.edu.

PMID: 38325938
DOI: 10.1016/j.clp.2023.11.007

Abstract

Neonates with a perinatal hypoxic insult and subsequent neonatal encephalopathy are at risk of acute pulmonary hypertension (aPH) in the transitional period. The phenotypic contributors to aPH following perinatal asphyxia include a combination of hypoxic vasoconstriction of the pulmonary vascular bed, right heart dysfunction, and left heart dysfunction. Therapeutic hypothermia is the standard of care for neonates with moderate-to-severe hypoxic ischemic encephalopathy. This review summarizes the underlying risk factors, causes of aPH in neonates with perinatal asphyxia, discusses the unique phenotypical contributors to disease, and explores the impact of the initial insult and subsequent therapeutic hypothermia on aPH.

Keywords: Acute pulmonary hypertension; Echocardiography; Hypoxic ischemic encephalopathy; Therapeutic hypothermia.

Publication types

Review

MeSH terms

Asphyxia / complications
Asphyxia / therapy
Asphyxia Neonatorum* / complications
Asphyxia Neonatorum* / therapy
Female
Humans
Hypertension, Pulmonary* / therapy
Hypothermia, Induced* / adverse effects
Hypoxia / etiology
Hypoxia-Ischemia, Brain* / therapy
Infant, Newborn
Pregnancy