Pathophysiology of persistent pulmonary hypertension of the newborn: Impact of the perinatal environment

Pôle Femme-Mère-Nouveau-né, Hôpital Jeanne-de-Flandre, CHRU de Lille, Lille, France. Electronic address: .
Archives of cardiovascular diseases (Impact Factor: 1.84). 03/2013; 106(3):169–177. DOI: 10.1016/j.acvd.2012.12.005

ABSTRACT La principale cause d’hypertension pulmonaire du nouveau-né résulte d’une vasodilatation pulmonaire insuffisante à la naissance, appelée « hypertension artérielle pulmonaire persistante du nouveau-né » (HTAPP). Ce syndrome est caractérisé par une élévation des résistances vasculaires pulmonaires, responsable d’un shunt droit-gauche par le foramen ovale et le canal artériel et d’une profonde hypoxémie. L’HTAPP est à risque vital lorsque qu’elle s’accompagne d’une défaillance circulatoire. La prise en charge nécessite un recrutement pulmonaire adéquat, l’inhalation de monoxyde d’azote et un support cardiovasculaire adapté. Néanmoins, la physiopathologie et la prise en charge sont toujours l’objet de recherches innovantes. Ainsi, de plus en plus d’arguments existent pour penser que l’environnement périnatal joue un rôle déterminant dans la genèse et l’aggravation de ce syndrome.

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