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PATHOPHYSIOLOGY OF PERSISTENT PULMONARY HYPERTENSION OF THE NEW BORNS

RISK FACTORS

Difficulty to deliver the child due to


breech presentation

Meconium aspiration

Increased pressure in the arteries

Abnormal smooth muscle development and hypertrophy in


the walls of the small pulmonary arteries and arterioles

Right to left shunting via the ductus


arteriosus or a foramen ovale

Intractable systemic hypoxia

Pulmonary and systemic


resistances are high
Leads to an increased
load on the heart

The load increases.

Right heart dilation Tricuspid insufficiency Right heart failure

Decreased cardiac out put


related to structural
abnormalities of the heart
The materials blocks 3
Medical Management
airway

Efficiency of Gas in Mechanical ventilator


decreased

FATIGUE related to
ongoing disease process
The material is very 4
irritating leading to
inflammation of airways Ineffective role
performance related to
ongoing disease process

Ineffective airway clearance related to 5


effects of the meconium in the lungs
1
Impaired gas exchange
related to effects of altered
ventilation and perfusion in
the lungs
2

References:

Medical-surgical Nursing by Brunner and


Suddarth pages 855-865

Pathophysiology Book – Doegens

http://depts.washington.edu/nicuweb/NICU-WEB/pphn.stm