PEDIATRICS Vol. 94 No. 3 September 1994, pp. 307-309
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Controversies in Management of Persistent Pulmonary Hypertension of the Newborn

Rakesh Sahni MD1, Jen-Tien Wung MD1, and L. Stanley James MD1

1 Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York, NY 10032

Forty years have passed since classical experiments in lambs documented that, during the transition from fetal to neonatal life, disturbances in pulmonary vascular tone and reactivity could lead to systemic hypoxemia.1 Shortly after that, James and Rowe demonstrated that hypoxia caused a precipitous fall in arterial saturation in human infants with evidence of incomplete postnatal adjustment to extrauterine respiration.2 Their finding of elevations in pulmonary vascular pressure and hypoxemia was interpreted as evidence for the "re-establishment of the fetal pattern of circulation." Additional, more detailed, observations of transitional changes in the central circulation of normal and abnormal infants were reported in the late 1950s.3-5

Submitted on June 24, 1994
Accepted on June 27, 1994