Ana Beatriz Nevarez Gilbert, Adrianne R. Bischoff
University of Iowa.
United States
NeoReviews
Neoreviews 2026; 27: e144-e156
DOI: 10.1542/neo.27-3-102
Abstract
Pulmonary hypertension (PH) is a serious and potentially life-threatening condition in neonates, often resulting from impaired transition from fetal to postnatal circulation. Although traditionally associated with elevated pulmonary vascular resistance and hypoxemic respiratory failure, PH in infants who are preterm encompasses a spectrum of pathophysiologic mechanisms and can be broadly categorized into 3 phenotypes: precapillary, postcapillary, and flow driven. Each phenotype presents with distinct hemodynamic features and clinical implications. Although pulmonary vasodilators such as inhaled nitric oxide remain a cornerstone of therapy for PH, their efficacy and safety vary significantly depending on the underlying phenotype and etiology. In this narrative review, we examine the evolving understanding of PH in infants who are premature and propose a physiologically grounded framework for diagnosis, phenotyping, and individualized management.
Category
Class III. Pulmonary Hypertension Associated with Lung Disease
Review Articles Concerning Pulmonary Vascular Disease
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: No