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Chapter 14 - Transfer of Child with Pulmonary Hypertension

Published online by Cambridge University Press:  17 December 2021

By
Kenneth MacGruer  and
Alison Pienaar
Edited by
Shelley Riphagen  and
Sam Fosker
Shelley Riphagen
Affiliation:
Evelina Children’s Hospital, London and South Thames Retrieval Service
Sam Fosker
Affiliation:
Evelina Children’s Hospital, London
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Summary

A large district general hospital has called to request a transfer of a 4 kg, 6-month-old ex 25-week premature infant, who is an inpatient in their level 3 NICU. The baby has not left hospital since birth and had a difficult neonatal course. He was intubated at birth and was not successfully extubated until 10 weeks of life. He has significant bronchopulmonary dysplasia (BPD) as a result of his extreme prematurity with secondary pulmonary hypertension diagnosed on echocardiogram. Although he has been relatively stable on high flow nasal cannula oxygen (HFNC) 8 L/min of flow and FiO2 0.4, he has deteriorated today. His usual medications are sildenafil for pulmonary hypertension; furosemide and spironolactone for chronic lung disease; and weaning doses of clonidine and chloral hydrate for agitation.

Type
Chapter
Information
Cases in Paediatric Critical Care Transfer and Retrieval Medicine , pp. 74 - 78
Publisher: Cambridge University Press
Print publication year: 2022

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References

Further Reading

Berger, RM, Beghetti, M, Humpl, T, et al. Clinical features of paediatric pulmonary hypertension: A registry study. Lancet 2012;379(9815):537–46.Google Scholar
Galiè, N, Humbert, M, Vachiery, J-L, et al. Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Respir J 2015; 46:903–75.Google ScholarPubMed
Haddad, F. Right ventricular function in cardiovascular disease. Circulation 117(13):1717–31.Google Scholar
Nichols, DG, Shaffner, DH, (eds). Rogers’ Textbook of Pediatric Intensive Care. 5th Ed. 2016.Google Scholar
van Loon, RL, Roofthooft, MT, Hillege, HL, et al. Pediatric pulmonary hypertension in the Netherlands: Epidemiology and characterization during the period 1991 to 2005. Circulation 2011;124(16):1755–64.Google Scholar

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