Morphometric analysis of the lung vasculature after extracorporeal membrane oxygenation treatment for pulmonary hypertension in newborns |
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Authors: | Email author" target="_blank">Arno?van?HeijstEmail author Remco?Haasdijk Freek?Groenman Frans?van der?Staak Christina?Hulsbergen-van de Kaa Ronald?de?Krijger Dick?Tibboel |
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Institution: | (1) Departments of Neonatology, University Medical Centre Nijmegen, Nijmegen, The Netherlands;(2) Department of Paediatric Surgery, Erasmus Medical Centre-Sophia Childrens Hospital, Rotterdam, The Netherlands;(3) Department of Paediatric Surgery, University Medical Centre Nijmegen, Nijmegen, The Netherlands;(4) Department of Pathology, University Medical Centre Nijmegen, Nijmegen, The Netherlands;(5) Department of Pathology, Erasmus Medical Centre-Sophia Childrens Hospital, Rotterdam, The Netherlands;(6) Department of Pediatrics, University Medical Centre Nijmegen, PO Box 9101, 6500 HB Nijmegen, The Netherlands |
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Abstract: | Persistent pulmonary hypertension in the newborn (PPHN) is characterised by increased medial and adventitial thickness in the lung vasculature. This study describes morphometry of lung vasculature after extracorporeal membrane oxygenation (ECMO) in newborns with PPHN, due to meconium aspiration syndrome, sepsis or idiopathic persistent pulmonary hypertension of the newborn (i-PPHN). Three groups were studied: newborns with PPHN treated with ECMO (n=9), newborns with PPHN not treated with ECMO (n=12) and age-matched controls without PPHN (n=11). In pulmonary arteries with an external diameter of less than 150 m, arterial media, adventitia and total wall thickness, expressed as a percentage of the external diameter, and their cross-sectional areas were calculated. Newborns with PPHN, compared with controls, demonstrated increased percentage of media thickness, adventitia thickness and total wall thickness, and increased medial, adventitial and total wall cross-sectional area. Newborns treated with ECMO, compared with those not treated so, showed a decreased percentage of media thickness and medial cross-sectional area in arteries with an external diameter less than 75 m, and decreased percentage of media thickness and decreased medial, adventitial and total wall cross-sectional area in arteries with an external diameter of 75–150 m. ECMO for persistent PPHN, due to meconium aspiration syndrome, sepsis or i-PPHN, reduces the abnormal morphometry of small pulmonary arteries. The underlying mechanisms contributing to this improved morphometry are yet unknown. |
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Keywords: | Morphometry Medial thickness Adventitial thickness ECMO Newborn |
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