PULMONARY HYPERTENSION IN NEWBORNS: THE 21 TREATMENT OPTIONS YOU SHOULD KNOW.

 Treatment Options for Pulmonary Hypertension in Newborns

Treatment for pulmonary hypertension in newborns depends on its cause.

There are treatments that can be given to children with pulmonary hypertension caused by abnormalities in the blood vessels of the lungs.

Treatment for congenital pulmonary hypertension can include the use of drugs to lower blood pressure in the body (such as medication that lowers blood pressure in the blood vessels in the lungs).

Treatment for hereditary pulmonary hypertension involves the use of a radioactive drug called dexamethasone.

You can always refer back to the risk factors, symptoms, and diagnosis of pulmonary hypertension in children before going through the treatment options in this article.

Now let’s see some of the available treatment methods for pulmonary hypertension in newborns as described below.

pulmonary hypertension in newborns

The Treatment options for Pulmonary Hypertension in Newborns are:

1. Prevention of Pulmonary Hypertension in Newborns

If you or your doctor suspect that your newborn has pulmonary hypertension, there are several things you can do to help prevent this condition from worsening and developing into what is known as congenital heart disease (CHD).

If your baby has a specific genetic disorder, you should be sure that all of the medications prescribed to treat the disorder are taken properly.

If your baby was born prematurely, ask your doctor for a physical exam, chest X-ray, and an echocardiogram at your baby's first appointment.

If you deliver your baby by C-section, make sure your doctor lets you know if the baby has high blood pressure immediately after the surgery.

Also, be sure that you follow your baby's immunization schedule. Therefore, the prevention of pulmonary hypertension in newborns is the first step in the treatment options.

2. Extracorporeal Membrane Oxygenation Support

Extracorporeal membrane oxygenation (ECMO) is a procedure that helps support the heart and lungs during a prolonged period of severe lung failure.

ECMO was originally developed to support heart and lung failure in adults, and now ECMO is used in heart failure in newborns with a similar condition.

The treatment for PHN, or newborn respiratory distress syndrome, involves infusing a type of blood in the lungs of the baby in order to increase oxygen levels in the blood.

Extracorporeal membrane oxygenation (ECMO) is the first treatment the baby receives in order to help alleviate the symptoms and allow the baby's heart to pump blood to the rest of the body.

Medications to treat pulmonary hypertension, the medications for PHN should include a drug to lower the level of oxygen in the blood.

However, the drug does not increase oxygen levels to normal levels, as it only brings oxygen levels into normal ranges.

A variety of blood pressure medications are also used to treat PHN.

3. Vasodilator

Newborns may need to be connected to a ventilator during treatment. When a baby is born with pulmonary hypertension, their heart and blood vessels are constricted, which often makes it hard for blood to flow.

This affects the lungs and blood flow throughout the body. The blood pressure in the blood vessels of the lungs is lower than the pressure in other parts of the body.

This means that the blood vessels are unable to pump enough blood to supply the lungs with oxygen.

This can cause the child's heart to beat faster and harder, which is a symptom known as hyperventilation.

A child with pulmonary hypertension will likely need oxygen, which can be supplied by a ventilator.

4. Phosphodiesterase Inhibitor

Phosphodiesterase inhibitors (PDEs) work in the blood vessels to prevent a build-up of calcium and arterial vasodilators.

The PDE inhibitors should not be used in those who have high levels of calcium in the blood or those who are allergic to them.

They work by stopping the enzyme from converting blood into smooth muscle, which can slow the blood flow through the blood vessels and prevent fluid build-up in the lungs.

Therefore, phosphodiesterase Inhibitors are an important treatment for patients with pulmonary hypertension.

pulmonary hypertension in newborns

5. Diuretics

Diuretics, such as furosemide (Lasix) and hydrochlorothiazide (HCTZ), may help to lower the blood pressure in someone with pulmonary hypertension.

People with pulmonary hypertension tend to have high blood pressure. This high blood pressure can prevent the heart from getting enough oxygenated blood and has a detrimental impact on its ability to pump oxygen to the body.

6. Palliative Shunting

When a baby is born with Pulmonary hypertension, doctors usually find that their blood oxygen levels are dangerously low.

This often causes the baby to have problems breathing. They may have to be rushed to the neonatal intensive care unit (NICU) or to a respiratory centre.

Doctors often try to treat pulmonary hypertension before these symptoms appear.

This may include removing blood from the body and then giving the blood to oxygenate it and injecting a medicine into the blood to lower blood pressure or increase the oxygen levels in the blood.

When a baby with pulmonary hypertension is born, doctors usually try to avoid invasive treatment in the first few hours.

7. Pulmonary Artery Banding

Pulmonary hypertension occurs when there is a narrowing of the pulmonary artery. The pulmonary artery connects the left side of the heart with the lungs.

When this is narrowed, it restricts the flow of blood and oxygen through the lungs to the rest of the body.

The wide diameter of the pulmonary artery means that it can become very narrow, which is often the case with premature babies.

The range of treatments used to treat the condition depends on the symptoms that the person has.

People with premature babies are often fitted with a pulmonary artery band (PAB). This is a tube-like instrument, similar to a stent, which can be inserted into the pulmonary artery to widen the vessels. PAB is a low-risk procedure, but it still carries some risks.

8. Surgical Shunt

A surgical shunt is a ventriculostomy tube that is surgically placed in the lungs to allow blood to bypass the pulmonary artery.

The surgical shunt directs the blood to the right side of the heart, away from the lungs, where it can flow normally.

This can lessen the pressure in the arteries and allow the blood to flow properly.

pulmonary hypertension in newborns

9. Surfactant Therapy

The treatment called surfactant therapy helps to improve blood flow in the lungs. If the blood flow in the lungs is too low, the blood will not be able to get enough oxygen to carry the body's vital functions.

A heart and lung transplant are usually the only long-term treatment available for this condition.

However, surfactant therapy can be used with various types of ventilation. Doctors often use a small pump, called turbos pray, to administer the drug into the blood.

The doctor will usually start this treatment right after birth. If the infant is not breathing well, the doctor may administer a nasal spray instead of a pump.

10. Antibiotics

In some cases, the cause of pulmonary hypertension in newborns is unknown.

However, antibiotics can help to lower the level of bacteria in the lungs and bring about a decrease pressure in the blood vessels.

If antibiotics are given shortly after birth, they can prevent the condition from getting worse.

In most cases, the treatment can be given as a series of injections.

pulmonary hypertension in newborns 

11. Antidotes

Doctors can also help treat pulmonary hypertension in newborns with an anti-rejection treatment called tacrolimus.

This helps the immune system stop fighting itself and continue to function. This is because the medications administered to treat the condition can cause infections in the body.

12. Oxygen Therapy

Oxygen therapy may be used to help babies with pulmonary hypertension.

 Doctors may decide to treat the symptoms of pulmonary hypertension in newborns with either oxygen or a breathing machine called a positive-pressure ventilator (PPRV).

The machine is used during the first few hours after birth, while oxygen is given by a cannula in the baby's nose.

By giving oxygen to the baby, the lungs can get enough oxygen. Without oxygen, the right side of the heart can work harder than the left side of the heart, which can cause the lungs to fail.

Some babies may also require a PPRV while still in the womb.

pulmonary hypertension in newborns 

13. Long-Term Oxygen Therapy

Some babies can benefit from long-term oxygen therapy. In this case, babies will typically be put on a continuous positive airway pressure (CPAP) machine for up to two to three months, or they may be given oxygen in their hospital room.

Long-term oxygen therapy may help to prevent babies from developing airway obstructions in their lungs so that they can start breathing on their own as soon as possible.

14. Cold solutions

The medical term for a cold solution is bradycardia and this medication is given to babies with bradycardia to reduce their heart rate.

Bradycardia occurs when the heart beats slowly but has no rhythm. This can lead to more babies becoming acutely ill and requiring intensive care in hospitals.

15. Transfusion

Transfusion, or blood transfusion, may help a newborn baby with pulmonary hypertension.

When pulmonary hypertension occurs in newborns, it may be caused by the heart not pumping enough blood such blood transfusion, may be helpful.

When the heart is unable to pump enough blood to these lungs, the lungs can become damaged.

And without proper treatment, the heart is unable to pump enough blood to supply oxygenated blood to the lungs and body.

Therefore, blood transfusion is a way to support the heart's ability to function and can also provide nutrients and blood cells, including red blood cells.

16. Surgery

Some treatment options for pulmonary hypertension in newborns include an open thoracotomy, in which a surgeon opens up the chest cavity.

A hypothermic mask is a procedure in which doctors place a cooling cap on the baby's head to help lower blood pressure.

A pulmonary artery catheterization an IVP or Holter monitor surgery is the best treatment option for most children with pulmonary hypertension, and this is typically performed when they are four months of age.

It usually involves opening the arteries that carry blood from the heart to the lungs.

This is usually done in the operating room and, when possible, a person can return home the same day.

17. Inotropes

Inotropes are pills given to infants with severe pulmonary hypertension to help their hearts beat normally.

Inotropes treat the medical condition called supraventricular tachycardia (SVT), which causes the heart to beat very fast, sometimes more than 500 beats per minute (bpm).

The goal of taking inotropes is to reduce the heart rate and prevent damage to the baby's heart and blood vessels.

Aspirin can also be prescribed as an inotropic. If you think your baby needs an inotropic, you should call your doctor.

18. Use Medications to Block Inflammation

The two treatments that doctors mostly use to treat the symptoms of pulmonary hypertension are non-invasive pulmonary artery catheterization (NIAC) and selective steroid treatment.

These techniques allow doctors to check for narrowing or blocked arteries in the lungs.

If pulmonary hypertension is caused by blocked arteries, they will send a balloon or catheter into the vessels and then blow air into them to clear them.

This is a non-invasive procedure, and the procedure only takes about 15 minutes.

But if the diagnosis is not from a pulmonary artery catheterization, they may try steroids to get the lungs to fill with fluid.

NIAC involves an ultrasound probe that sends sound waves to the heart and lungs, to help determine which vessels are blocked.

19. Control Cardiovascular Pressure

Applying a monitor to a newborn to monitor his/her heart rate and making sure that the baby does not have an elevated heart rate is an important part of the treatment of pulmonary hypertension in newborns.

20. Use Medications for Seizures that Might Occur with Pulmonary Hypertension (PH)

Some babies with PH are prone to seizures, which require treatment. Some babies with PH are prone to seizures, which require treatment.

There are medications that can reduce the symptoms of the condition. To treat seizures, doctors may prescribe drugs that reduce or stop them.

These types of seizures can cause excessive crying and can affect a child's development.

To find out whether a child has seizures, it is important to monitor their development and examine them for other problems.

The first way to reduce the risk of seizures in infants with PH is to monitor the child's development.

21. Perform a Heart Transplant If a Baby Cannot Be Treated Successfully 

Depending on the severity of pulmonary hypertension in newborns, the treatment could also include a heart transplant.

For some infants with pulmonary hypertension, doctors will perform a heart transplant if other treatments did not work.

The Doctors can repair damage to the pulmonary artery, but not cure the condition itself.

Doctors will sometimes transplant a patient's only chance at survival. This will require the child to stay in the hospital for 3-4 months.

pulmonary hypertension in newborns

Conclusion

Pulmonary hypertension (PH) is a rare and serious condition that can occur in children. The type of PH a child has will be determined by the doctor based on the child’s symptoms and medical history.

The doctor will also use imaging tests to help diagnose the condition. Treatment for pulmonary hypertension depends on its cause.

If your child has pulmonary hypertension caused by heart defects or other abnormalities, you should talk to your doctor about treatment options.

Depending on the cause, your child may need surgery to repair the defect or abnormalities.

If your child has pulmonary hypertension caused by an infection, he or she may need antibiotics to treat the infection.

Be sure you are very conversant with the risk factors, symptoms and diagnosis of pulmonary hypertension in newborns in order to get the right treatments.