Asphyxia, Therapeutic Hypothermia, and Pulmonary Hypertension

Acute neonatal pulmonary hypertension is a common consequence of perinatal hypoxia that is even more pronounced in neonates with moderate -to -severe HIE. The pathogenesis of the association between perinatal asphyxia and aPH is multifactorial and results from a combination of hypoxic vasoconstriction of the pulmonary vascular bed and primary insults to right or left ventricular performance or other pathophysiologic disorder. The diagnosis of aPH requires clinical awareness of risk factors, recognition of hemodynamic changes, and understanding of the different imaging modalities to provide comprehensive information regarding phenotypes, disease severity, and the influences of pulmonary vascular disease and cardiac dysfunction. Longitudinal assessment can offer valuable physiologic insights into disease progression and response to therapies.