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The interplay between pressure, flow, and resistance in neonatal pulmonary hypertension

Lookup NU author(s): Dr David Crossland

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Abstract

© 2022 Elsevier Ltd. Pulmonary hypertension, conventionally defined by absolute pulmonary artery pressure, is the result of a range of diagnoses that can result in clinical problems in neonatal practice. Causes include persistent pulmonary hypertension of the newborn, congenital heart disease, and left heart dysfunction, as well as the normally high pulmonary artery resistance in neonates. Elucidating the cause of pulmonary hypertension is vital to guide appropriate management. A first principles approach based on hemodynamic calculations provides a framework for the diagnostic work up and subsequent therapy. Central to this is the equation ‘pressure = flow x resistance’ and knowledge of factors contributing to flow and resistance and their impact on pulmonary artery pressure. While formal, accurate, calculation of each element is usually not required or deliverable in small infants, clinical and echocardiographic parameters, combined with an understanding of the interplay between pressure, flow, and resistance, significantly improves the assessment and management of neonatal pulmonary hemodynamics.

Publication metadata

Author(s): Jones CB, Crossland DS

Publication type: Review

Publication status: Published

Journal: Seminars in Fetal and Neonatal Medicine

Year: 2022

Volume: 27

Issue: 4

Print publication date: 01/08/2022

Online publication date: 18/06/2022

Acceptance date: 02/04/2018

ISSN (print): 1744-165X

ISSN (electronic): 1878-0946

Publisher: W.B. Saunders Ltd

URL: https://doi.org/10.1016/j.siny.2022.101371

DOI: 10.1016/j.siny.2022.101371

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