Pulmonary HTN

[Mimsy909]

Recently we've seen an increase in NICU grads being admitted to our PICU after a short time at home. They are being diagnosed with pulmonary hypertension, something that's not mentioned to the parents as a potential complication of their prematurity despite courses that have included long-term ventilation with oscillators and d/c with meds and O2. We've had to trach and send home a couple with ventilators. Ethics aside, where might I find a couple of articles or information I might have available for parents to help explain this phenomenon? Is this something that any of you experience? The NICU is actually in another hospital across the street from the one I work in, two different 'corporations,' govern the hospitals, attendings don't collaborate across the divide to provide continuity of care for these little ones, but at least our residents work both sides of the street so when one of them bounces back somebody knows them. You can imagine the level of distrust that accompanies the parents. Any comments are appreciated.

[SteveNNP, MSN, NP]

Here are a couple of sites with parent-level info. Unfortunately PPHN is something, even if treated, can return with a vengeance. Any stress can send them back into a hypertensive crisis. We see it pretty often in NICU, treat it with nitric oxide, viagra and sometimes ECMO, but each baby is different. Some never fully get over it.....

http://www.thechildrenshospital.org/wellness/info/parents/20830.aspx

http://www.upmc.com/HealthManagement/ManagingYourHealth/HealthReference/Diseases/?chunkiid=222846

http://www.pediatrix.com/body.cfm?id=7&action=detail&AEProductID=Client_PDX52475423&AEarticleiD=135

[Mimsy909]

Thanks Steve, that info looks great. We've had success treating the critters with NO and Sildenafil (our attendings do not want us to use the name Viagra). Fortunately, no ECMO. Since we've had a few admissions for PPHN and the parents were not prepared for what their preemie has now developed, this info will help all of us.