Understanding and treating pulmonary hypertension in congenital diaphragmatic hernia

M. Pierro, B. Thébaud

Research output: Contribution to journalReview articlepeer-review

Abstract

Lung hypoplasia and pulmonary hypertension are classical features of congenital diaphragmatic hernia (CDH) and represent the main determinants of survival. The mechanisms leading to pulmonary hypertension in this malformation are still poorly understood, but may combine altered vasoreactivity, pulmonary artery remodeling, and a hypoplastic pulmonary vascular bed. Efforts have been directed at correcting the "reversible" component of pulmonary hypertension of CDH. However, pulmonary hypertension in CDH is often refractory to pulmonary vasodilators. A new emerging pattern of late (months after birth) and chronic (months to years after birth) pulmonary hypertension are described in CDH survivors. The true incidence and implications for outcome and management need to be confirmed by follow-up studies from referral centers with high patient output. In order to develop more efficient strategies to treat pulmonary hypertension and improve survival in most severe cases, the ultimate therapeutic goal would be to promote lung and vascular growth.

Original languageEnglish
Pages (from-to)357-363
Number of pages7
JournalSeminars in Fetal and Neonatal Medicine
Volume19
Issue number6
DOIs
Publication statusPublished - Dec 1 2014

Keywords

  • Congenital diaphragmatic hernia
  • Lung hypoplasia
  • Prenatal therapy
  • Pulmonary hypertension
  • Vasodilator therapy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Medicine(all)

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