Persistance de l’Hypertension Pulmonaire du Nouveau-Né (PPHN)

The provided text appears to be a medical document related to Postnatal Pulmonary Hemorrhage Syndrome (PPHN) management. Here's a condensed version of the key points: **Diagnostic Tests:** * Echocardiography to screen for and diagnose PPHN and rule out structural heart lesions * Echocardiography with Doppler and color-flow mapping to assess intracardiac shunts and pulmonary artery pressures * Cranial ultrasonography to assess for intraventricular bleeding and peripheral areas of hemorrhage or infarct * Brain computed tomography scanning or magnetic resonance imaging to evaluate central nervous system injury **Procedures:** * Cardiac catheterization is rarely used due to echocardiographic findings being typically diagnostic **Management Principles:** * Continuous monitoring of oxygenation, blood pressure, and perfusion * Maintaining a normal body temperature * Correction of electrolytes/glucose abnormalities and metabolic acidosis * Nutritional support * Minimal stimulation/handling of the newborn * Minimal use of invasive procedures (e.g., suctioning) **Medical Therapy:** * Inotropic support (e.g., dopamine, dobutamine, milrinone) * Surfactant administration for premature and full-term newborns with parenchymal lung disease * Endotracheal intubation and mechanical ventilation to maintain normal functional residual capacity * High-frequency ventilation for newborns with underlying parenchymal lung disease and low lung volumes * Correction of hypoglycemia, hypocalcemia, acidosis, and alkalosis * Induced paralysis (controversial) and ECMO use when optimal ventilatory support fails to maintain acceptable oxygenation and perfusion **Pharmacotherapy:** * Inhaled pulmonary vasodilators (e.g., nitric oxide) and supplemental oxygen * Systemic vasodilators for chronic PPHN after the newborn period * Prostaglandin E1 if the ductus arteriosus is closed or restrictive in the setting of suprasystemic pulmonary artery pressures and/or right ventricular dysfunction leading to poor systemic perfusion

Combattre Hypertension – FR

Combattre Hypertension – FR

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