Persistent Pulmonary Hypertension of the Newborn

The lungs did not reinflate when the valve was closed. In addition to closing off the opening to the atmosphere, the excess air in the intrapleural space must be removed to decrease intrapleural pressure below atmospheric pressure before the lungs will reinflate.

The presence of fluid in the alveolar space could potentially cause the lung capacity to be effected as well.

other intense tests can be done to make the diagnosis much clearer such as Doppler echocardiogram, this uses sound waves to show the function of the right ventricle to measure the blood flow through the heart valves, and then calculate the systolic pulmonary artery pressure. There is also an X-ray, this is done on the chest. This can show any increase or decrease in size of the right ventricle and arteries. A simpler test such as the 6-minute walk test, this controls exercise patience level and blood oxygen saturation level during exercise. There is also a Pulmonary function test, this seeks for other lung conditions such as chronic obstructive pulmonary disease and idiopathic pulmonary fibrosis compared to others. Also there is a 'Polysomnogram or overnight oximetry', this monitors sleep apnea (results in low oxygen levels at night). Also a right heart catheterization, this measures various heart pressures ( inside the pulmonary arteries, coming from the left side of the heart), the rate at which the heart is able to pump blood, and finds any leaks between the right and left sides of the heart.

2. The defect in Caleb’s heart allows blood to mix between the two ventricular chambers. Due to this defect would you expect the blood to move from left-to-right ventricle or right-to-left ventricle during systole? Explain your answer based on blood pressure and resistance in the heart and great vessels. It goes left to right during systole. The difference is normally, oxygen-poor (blue) blood returns to the right atrium from the body, travels to the right ventricle, and then is pumped into the lungs where it receives oxygen. Oxygen-rich (red) blood returns to the left atrium from the lungs, passes into the left ventricle, and then is pumped out to the body through the aorta. But when an infant has ventricular septal defect it still allows oxygen-rich (red) blood to pass from the left ventricle, through the opening in the septum, and then mix with oxygen-poor (blue) blood in the right ventricle. (ROCHESTER.EDU) but instead when systole occurs the blood gets mixed because of the septum therefore heart needs to pump harder to ensure that enough blood with oxygen reaches the body.

Air escaped from the lung into the pleural space. Eventually, enough air collected in the pleural space to cause the mediastinum to shift twoard the right. The collapsed left lung, increased intrapleural pressure, and rightward shift make it difficult to ventilate A.W.

In a normal human being the heart correctly functions by the blood first entering through the right atrium from the superior and inferior vena cava. This blood flow continues through the right atrioventricular valve into the right ventricle. The right ventricle contracts forcing the pulmonary valve to open leading blood flow through the pulmonary valve and into the pulmonary trunk. Blood is then distributed from the right and left pulmonary arteries to the lungs, where carbon dioxide is unloaded and oxygen is loaded into the blood. The blood is returned from the lungs to the left

Premature birth has been linked to a vast array of lungs problems, the earlier the birth the greater risk of health complications(Davis R and Mychaliska G, 2013). A majority of the health problems will affect the infant for the rest of their life (Davis R and Mychaliska G, 2013). Infants born between the canalicular and the saccular period (week 25) have lung development that is unsuitable for gas exchange (Davis R and Mychaliska G, 2013). Two major complications that arise with undeveloped lungs is bronchopulmonary dysplasia, and pulmonary arterial hypertension (Mahgoub L. et al. 2017).

The increased resistance of blood flow through the pulmonary semilunar valve from the right ventricle backs up the pressure of blood

The blood that does not cross the foramen ovale into the left atrium is emptied into the right ventricle which is then pumped into the pulmonary artery to be carried to the lungs. The third fetal shunt is encountered; the ductus arteriosus allows blood to be shunted from the pulmonary artery to the aorta and systemic arteries following. Blood that does go to the lungs are returned by the pulmonary veins to the left atrium and emptied into the left ventricle. (Perinatal and Pediatric Respiratory Care, Ch2 p 17-18) Shortly after birth due to changes in vascular resistance blood is redirected to the lungs for oxygenation and these shunts are no longer required leading to their closure within a few days postpartum. In HLHS, because the left heart structures are insufficient to receive and pump adequate amounts of oxygenated blood to supply the tissues the patency of the foramen ovale and the ductus arteriosus are essential to sustaining life. (PubMed – ADAM Medical Encyclopedia, 2013) Medical intervention is needed to maintain the patency of the ductus arteriosus and an atrial septal defect is created in place of the foramen ovale.

Diagnosing the disease can be relatively simple, but this depends on accurate patient history and ones ability to recognize varied clinical signs and then perform diagnostic procedures. These diagnostic procedures may include antigen testing, x-rays, ultrasonography, angiography, a complete blood count, the Knott’s or Filter test, and in the worst case necropsy.

Patent Ductus Arteriosus (PDA) is one of the common congenital left to right cardiac defects seen in children. The ductus arteriosus is a large communication pathway that is naturally patent in the fetus, connecting the trunk of the major pulmonary artery to the descending aorta (Shinde, Basantwani, & Tendolkar, 2016). During the fetal life, ductus arteriosus is a normal structure that allows the blood to pass from the right ventricle to the descending aorta by bypassing the pulmonary circulation. The ductus arteriosus is an important structure in the fetal development as it allow the blood flow to the rest of the fetal organ and structure. In fetus pulmonary

Necrosis of the cells in the small, lower airways occurs, and mucous secretions are increased (Conquest, Cremonesini, & Neill, 2013). Because of the ciliary damage in the infants’ lungs, it is almost impossible for the secretions to be cleared. Bronchiolar level obstruction is caused by these mucosusal secretions, as is desquamation of the dead skin cells and edema (Conquest, Cremonesini, & Neill, 2013). Plugs of soughed, necrotic epithelium and fibrin in the airways will cause partial or total obstruction to airflow, making it very difficult for he infant to exhale which will consequently result in air becoming trapped and will reduce gaseous exchange (Conquest, Cremonesini, & Neill, 2013).

The human body is a very complex organism composed of different types of systems and functions. All the functions that each system has, is what makes possible for the body to obtain life. One of the most important systems in one’s body is the circulatory system, where the heart, the lungs, and the blood vessels work together to form the circle part of the circulatory system. The pumping of the heart forces the blood on its journey. The body’s circulatory system really has three parts: pulmonary circulation, coronary circulation, and systemic circulation. Each part must be working independently in order for them to all work together. However, when one of the parts of the circulatory system does not

Parenchymal destruction due to emphysema also contributes to airflow limitation and leads to decreased gas transfer .

The placenta is a major source of fetal prostaglandins and its removal after birth allows for the lungs to expand and become metabolically active, where most prostaglandins are degraded. This, in combination with increased pulmonary oxygen tension, in healthy full-term infants, normally causes functional closure of the ductus arteriosus within 15 hours after birth.