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Help us improve the health of all moms and babies

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Join March of Dimes in our mission to prevent birth defects and premature birth. Learn about our research, advocacy, and resources for families.

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Pulmonary Stenosis | Children's Hospital of Philadelphia

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Learn about pulmonary stenosis, a condition that causes the heart to work harder to pump enough blood to the body, including how it is treated.

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This webpage provides general information on choosing and using a breast pump.

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Sometimes, the best way to progress isn't to advance - to step up with more money, more technology, more modernity. It's to retreat.

Towards the end of the 1970s, the Mother and Child Institute in Bogota, Colombia, was in deep trouble. The institute was the city's obstetrical reference hospital, where most of the city's poor women went to give birth. Nurses and doctors were in short supply. In the newly created neonatal intensive care unit, there were so few incubators that premature babies had to share them - sometimes three to an incubator. The crowded conditions spread infections, which are particularly dangerous for preemies. The death rate was high.

Dr. Edgar Rey, the chief of the pediatrics department, could have attempted to do what many other hospital officials would have done: wage a political fight for more money, more incubators and more staff.

He would likely have lost. What was happening at the Mother and Child Institute was not unusual. Conditions were much better, in fact, than at most public hospitals in the third world. Hospitals that mainly serve the poor have very little political clout, which means that conditions in their wards sometimes seem to have been staged by Hieronymous Bosch. They have too much disease, too few nurses and sometimes no doctors at all. They can be so crowded that patients sleep on the floor and so broke that people must bring their own surgical gloves and thread. I recently visited a hospital in Ethiopia that didn't even have water - the nurses washed their hands after they got home at night.

Proof that more money and more technology isn't always the answer.

Rey thought about the basics. What is the purpose of an incubator? It is to keep a baby warm, oxygenated and nourished - to simulate as closely as possible the conditions of the womb. There is another mechanism for accomplishing these goals, Rey reasoned, the same one that cared for the baby during its months of gestation. Rey also felt, something that probably all mothers feel intuitively: that one reason babies in incubators did so poorly was that they were separated from their mothers. Was there a way to avoid the incubator by employing the baby's mother instead?

What he came up with is an idea now known as kangaroo care. Aspects of kangaroo care are now in use even in wealthy countries - most hospitals in the United States, for example, have adopted some kangaroo care practices. But its real impact has been felt in poor countries, where it has saved countless preemies' lives and helped others to survive with fewer problems.

Agence France-Presse

In Rey's system, a mother of a preemie puts the baby on her exposed chest, dressed only in a diaper and sometimes a cap, in an upright or semi-upright position. The baby is strapped in by a scarf or other cloth sling supporting its bottom, and all but its head is covered by mom's shirt. The mother keeps the baby like that, skin-to-skin, as much as possible, even sleeping in a reclining chair. Fathers and other relatives or friends can wear the baby as well to give the mother a break. Even very premature infants can go home with their families (with regular follow-up visits) once they are stable and their mothers are given training.

The babies stay warm, their own temperature regulated by the sympathetic biological responses that occur when mother and infant are in close physical contact. The mother's breasts, in fact, heat up or cool down depending on what the baby needs. The upright position helps prevent reflux and apnea. Feeling the mother's breathing and heartbeat helps the babies to stabilize their own heart and respiratory rates. They sleep more. They can breastfeed at will, and the constant contact encourages the mother to produce more milk. Babies breastfeed earlier and gain more weight.

The physical closeness encourages emotional closeness, which leads to lower rates of abandonment of premature infants. This was a serious problem among the patients of Rey's hospital; without being able to hold and bond with their babies, some mothers had little attachment to counter their feelings of being overwhelmed with the burdens of having a preemie. But kangaroo care also had enormous benefits for parents. Every parent, I think, can understand the importance of holding a baby instead of gazing at him in an incubator. With kangaroo care, parents and baby go through less stress. Nurses who practice kangaroo care also report that mothers also feel more confident and effective because they are the heroes in their babies' care, instead of passive bystanders watching a mysterious process from a distance.

The hospitals were the third beneficiaries. Kangaroo care freed up incubators. Getting preemies home as soon as they were stable also lessened overcrowding and allowed nurses and doctors to concentrate on the patients who needed them most.

Kangaroo care has been widely studied. A trial in a Bogota hospital of 746 low birth weight babies randomly assigned to either kangaroo or conventional incubator care found that the kangaroo babies had shorter hospital stays, better growth of head circumference and fewer severe infections. They had slightly better rates of survival, but the difference was not statistically significant. Other studies have found fewer differences between kangaroo and conventional methods. A conservative summary of the evidence to date is that kangaroo care is at least as good as conventional treatment - and perhaps better.

In much of the world, however, whether a mother's chest is better or worse than an incubator is not the point. Hospitals have no incubators, or have only a few. And millions of mothers never see a hospital - they give birth at home. In very poor countries, where pregnant women are unlikely to get the food and care they need, low birth weight babies are very common - nearly one in five babies in Malawi, for example, is too small. Nearly a million low birth weight babies die each year in poor countries. But thanks to kangaroo care, many of them can be saved. The Manama Mission Hospital in southwest Zimbabwe, for example, had available only antibiotics and piped oxygen in its neonatal unit. Survival rates for babies born under 1500 grams (3.3 lbs.) improved from 10 percent to 50 percent when kangaroo care was started in the 1980s. In 2003, the World Health Organization put kangaroo care on its list of endorsed practices.

Dr. Rey took a challenge that most people would assume requires more money, personnel and technology and solved it in a way that requires less of all three. I am not a romantic who wants to abandon modern medical care in favor of traditional solutions. People with AIDS in South Africa need antiretroviral therapy, not traditional healers' home brews. If you are bitten by a cobra in India, you should not go to the temple. You should go to the hospital for antivenin. Modern medical care is essential and technology very often saves lives.

Kangaroo care, however, is modern medical care, by which I mean that its effectiveness is proven in randomized controlled trials - the strongest kind of evidence. And because it is powered by the human body alone, it is theoretically available to hundreds of millions of mothers who would otherwise have no hope of saving their babies.

But theoretical availability is only helpful for theoretical babies. Another of kangaroo care's important innovations is that its inventors realized that ideas don't travel by themselves. They established a way to get the practice from Bogota into hospitals and clinics all over the world - something that takes a lot more creativity and work than it sounds. On Saturday I'll respond to comments and talk about how kangaroo care has been able to reach the places that need it most.
Tina Rosenberg won a Pulitzer Prize for her book "The Haunted Land: Facing Europe's Ghosts After Communism." She is a former editorial writer for The Times and now a contributing writer for the paper's Sunday magazine. Her new book, "Join the Club: How Peer Pressure Can Transform the World," is forthcoming from W.W. Norton.

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Sometimes, the best way to progress isn't to advance - to step up with more money, more technology, more modernity. It's to retreat. Towards the end of the 1970s, the Mother and Child Institute in Bogota, Colombia, was in deep trouble.

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Kangaroo care, also called skin-to-skin, is a wonderful way to be close to your baby.

What is kangaroo care?

Kangaroo care means holding your diapered baby on your bare chest (if you're the father) or between your breasts (if you're the mother). Be sure to put a blanket over your baby's back to keep him warm. Kangaroo care is great for you and your baby.

How can kangaroo care help your baby?

Kangaroo care may help your baby:

Keep his body warm

Keep his heart and breathing regular

Gain weight

Spend more time in deep sleep

Spend more time being quiet when awake and less time crying

Have a better chance of being able to breastfeed

How can kangaroo care help you?

Kangaroo care may help you:

Make more breast milk

Reduce your stress

Feel close to your baby

Kangaroo care has emotional benefits for you, too. It builds your confidence as you provide intimate care that can improve your baby's health and well being. You are giving something special to your baby that only you can give. By holding your baby skin-to-skin, you will feel the experience of new parenthood and closeness to your baby. Kangaroo care is healing in many ways, for both you and your baby.

When can you start kangaroo care?

Ask your NICU staff about its policy on kangaroo care. Some NICUs postpone kangaroo care until the infant is medically stable, while others use it from birth onward. Kangaroo care is safe and beneficial, even if your baby is connected to machines. Whatever your situation, kangaroo care is a precious way to be close to your baby. You will cherish this time.

Last reviewed: August, 2014

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Kangaroo care, also called skin-to-skin, is a wonderful way to be close to your baby. Kangaroo care means holding your diapered baby on your bare chest (if you're the father) or between your breasts (if you're the mother). Be sure to put a blanket over your baby's back to keep him warm.

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Skip to Content

What do your blood pressure numbers mean?
The only way to know (diagnose) if you have high blood pressure (HBP or hypertension) is to have your blood pressure tested. Understanding your blood pressure numbers is key to controlling high blood pressure.

Healthy and unhealthy blood pressure ranges
Learn what's considered normal, as recommended by the American Heart Association.

BLOOD PRESSURE CATEGORY

SYSTOLIC mm Hg
(upper number)

DIASTOLIC mm Hg
(lower number)

NORMAL

LESS THAN 120

and

LESS THAN 80

ELEVATED

120 - 129

and

LESS THAN 80

HIGH BLOOD PRESSURE
(HYPERTENSION) STAGE 1

130 - 139

or

80 - 89

HIGH BLOOD PRESSURE
(HYPERTENSION) STAGE 2

140 OR HIGHER

or

90 OR HIGHER

HYPERTENSIVE CRISIS
(consult your doctor immediately)

HIGHER THAN 180

and/or

HIGHER THAN 120

Enter Your Blood Pressure

Blood pressure categories
The five blood pressure ranges as recognized by the American Heart Association are:

Normal blood pressure
Congratulations on having blood pressure numbers that are within the normal (optimal) range of less than 120/80 mm Hg. Keep up the good work and stick with heart-healthy habits like following a balanced diet and getting regular exercise.

Elevated
Elevated blood pressure is when readings are consistently ranging from 120-129 systolic and less than 80 mm Hg diastolic. People with elevated blood pressure are likely to develop high blood pressure unless steps are taken to control it.

Hypertension Stage 1
Hypertension Stage 1 is when blood pressure is consistently ranging from 130-139 systolic or 80-89 mm Hg diastolic. At this stage of high blood pressure, doctors are likely to prescribe lifestyle changes and may consider adding blood pressure medication based on your risk of atherosclerotic cardiovascular disease (ASCVD) such as heart attack or stroke. You can learn more about your risk by using the Check. Change. Control. Calculator™.

Hypertension Stage 2
Hypertension Stage 2 is when blood pressure is consistently ranging at levels of 140/90 mm Hg or higher. At this stage of high blood pressure, doctors are likely to prescribe a combination of blood pressure medications along with lifestyle changes.

Hypertensive crisis
This is when high blood pressure requires medical attention.If your blood pressure readings suddenly exceed 180/120 mm Hg, wait five minutes and test again. If your readings are still unusually high, contact your doctor immediately. You could be experiencing a hypertensive crisis. If your blood pressure is higher than 180/120 mm Hg and you are experiencing signs of possible organ damage such as chest pain, shortness of breath, back pain, numbness/weakness, change in vision, difficulty speaking, do not wait to see if your pressure comes down on its own. Call 9-1-1.

Your blood pressure numbers and what they mean
Your blood pressure is recorded as two numbers:

Systolic blood pressure (the upper number) - indicates how much pressure your blood is exerting against your artery walls when the heart beats.

Diastolic blood pressure (the lower number) - indicates how much pressure your blood is exerting against your artery walls while the heart is resting between beats.

Which number is more important?
Typically, more attention is given to systolic blood pressure (the top number) as a major risk factor for cardiovascular disease for people over 50. In most people, systolic blood pressure rises steadily with age due to the increasing stiffness of large arteries, long-term build-up of plaque and an increased incidence of cardiac and vascular disease.

However, elevated systolic or diastolic blood pressure alone may be used to make a diagnosis of high blood pressure. And, according to recent studies, the risk of death from ischemic heart disease and stroke doubles with every 20 mm Hg systolic or 10 mm Hg diastolic increase among people from age 40 to 89.

Why blood pressure is measured in mm Hg
The abbreviation mm Hg means millimeters of mercury. Why mercury? Mercury was used in the first accurate pressure gauges and is still used as the standard unit of measurement for pressure in medicine.

Taking your pulse versus checking your blood pressure
Your blood pressure and heart rate (pulse) are two separate measurements and indicators of health. Learn more about the difference between blood pressure and heart rate.
This content was last reviewed November 2017.

*All health/medical information on this website has been reviewed and approved by the American Heart Association, based on scientific research and American Heart Association guidelines. Use this link for more information on our content editorial process.

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Use our blood pressure chart to learn what your blood pressure numbers mean. Systolic, diastolic? The American Heart Association helps you understand the various levels of blood pressure and how high blood pressure or hypertension is defined. Also learn about prehypertension, hypertension, hypertensive crisis, and what is a healthy blood pressure.

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Acid-Base Calculator for arterial blood gases (ABG).

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Anatomy related to a tracheostomy with tracheostomy tube placement

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The National Council of State Boards of Nursing (NCSBN) is a not-for-profit organization whose purpose is to provide an organization through which boards of nursing act and counsel together on matters of common interest and concern affecting the public health, safety and welfare, including the development of licensing examinations in nursing.

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Chronic Lung Disease | Conditions & Treatments | UCSF Benioff Children's Hospital

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Treatment for chronic lung disease depends on the severity of the condition. Therapy involves vaccinations to ward off infections, and oxygen to help babies breathe normally until their lungs improve. Some babies may need a medicine, called a diuretic, which makes them pass more urine to remove extra fluid from around their lungs.

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University of Iowa Stead Family Children's Hospital

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Jonathan M. Klein, MD
Peer Review Status: Internally Peer Reviewed
SensorMedics 3100A Oscillatory Ventilator
The 3100A is a true high frequency oscillator with a diaphragmatically sealed piston driver. It is theoretically capable of ventilating patients up to 30 kg. Tidal volume typically delivered ≈ 1.5-3.0 cc/kg (< dead space). The 3100A is an extremely efficient ventilator secondary to an active expiratory phase, but it is not capable of delivering sigh breaths for alveolar recruitment.

INITIAL SETTINGS

FREQUENCY

Set initially at 10 Hz (600 BPM) for term infants and 15 Hz (900 BPM) for premature infants (< 2.5 kg). For children between 6-10 kg, use 8 Hz, and for children > 10 kg, use 6 Hz for an initial setting.

INSPIRATORY TIME (I.T.)

Set initially at 33% (e.g. 22 milliseconds at 15 Hz, 41 milliseconds at 8 Hz, 55 milliseconds at 6 Hz).

1) Warning - The percent of I.T. should never be increased because it will lead to air trapping and fulminant barotrauma. Total I.T. should only be increased by decreasing frequency, thus leaving the I:E ratio constant. I.T. can be decreased to 30% to heal air-leaks.

2) I:E ratio: ≈ 1:2 for 3-15 Hz at 33% I.T.

POWER

A rough representation of the volume of gas generated by each high frequency wave. Range (1.0 - 10.0). Maximum true volume of gas generated by the piston is 365 cc. Maximum amplitude or volume delivered is highly variable and depends on the following factors: circuit tubing (compliance, length and diameter), humidifier (resistance and compliance - water level), ET tube diameter and length (FLOWis directly proportional to , where r = radius of airway and l = length of airway), the patient's airways and compliance.

1) Set the POWER initially at 2.5 if wt <2.0 kg, 3.0 if wt < 2.5 kg, 4.0 if wt 2.5 - 4.0 kg, 5.0 if wt 4.0 - 5.0 kg, 6.0 if wt < 10 kg, 7.0 if wt > 20 kg.

Check ABG's every 15-20 min until , i.e., titrate POWER setting based on PaCO2 desired.

Chest wall needs to be vibrating. If not vibrating, increase power.

Many HFOV centers have you order amplitude or delta P (ƒ¢P) to regulate ventilation instead of power. We have decided that the Power setting is a more reliable way of adjusting this ventilator and thus we order changes in power in order to regulate ventilation.

2) Alveolar ventilation is directly proportional toPOWER, so the level ofPaCO2 is inversely proportional to the power.

3) During HFOV, alveolar ventilation (Ve) ≈ (TV)2 f as compared to CMV where Ve ≈ TV(R). Thus we primarily adjust the power (amplitude) to change tidal volume in order to manipulate ventilation.
4) Management of ABG's (Ventilation - Ve):
5)Warning - It is extremely important to normalize PaCO2 rapidly by weaning Power in order to avoid volutrauma from excessive tidal volumes.Check ABG's frequently (Q15-20 min) and decrease POWER accordingly until PaCO2 > 35. A PaCO2< 35 correlates with an increased risk of pneumothorax. Thus to minimize the risk of volutrauma, it is important to use the least amount of TV (POWER or AMPLITUDE) possible to achieve ventilation.

6) Hypercarbia - If PaCO2 still remains elevated at high POWER setting (>8.0), decrease FREQUENCY by 2 Hz every 15-20 min until maximum tidal volume is reached (3-4 Hz at a POWER of 10.0). The lower frequency leads to a longer I.T. leading to a larger tidal volume of gas being displaced towards the infant. This increased TV leads to improved alveolar ventilation (HFOV, Ve ≈ (TV)2f).

7) Manual Ventilation: Hand bagging while on the SensorMedics Ventilator should be avoided secondary to the risk of barotrauma due to over distention. Suctioning should be performed using just the ventilator breaths alone (an inline suctioning adapter would be best). If bagging has to be done, the PIP while bagging should not exceed 8-10 cm above the MAP and a PEEP of 6-8 cm should be maintained as tolerated.

MAP

Oxygenation on HFOV is directly proportional to MAP, which is similar to CMV, however with the SensorMedics HFOV the MAP is generated by PEEP. Thus during HFOV: MAP = PEEP.
1. Initial MAP Settings:
2. Management of ABG's (Oxygenation is directly proportional to MAP):

MANAGEMENT STRATEGIES

The SensorMedics HFOV is usually used for premature infants, term infants or young children with respiratory failure not responsive to CMV.

TERM INFANT WITH SEVERE RESPIRATORY FAILURE (PPHN, MAS, GBS pneumonia, RDS)

Start at a frequency of 10 Hz and a Power of 3.0 to 5.0. Initial MAP 4 cm above MAP while on CMV. Check CXR 2 hrs after converting to HFOV, then adjust MAP to achieve optimal lung volume (9-10 ribs expanded).

If not oxygenating, increase MAP by 2 cm every hour until oxygenation improves. Adjust Power to keep PaCO2 45-55.

AIRLEAKS

Pneumothorax or PIE

The goal is to minimize both tidal volumes and peak pressures generated by any given TV. Practice permissive hypercarbia and accept high PaCO2's to minimize the TV.

Tolerate transiently increased FiO2 requirements (0.6 - 1.0) in order to keep MAP at a minimum.

Use a FREQUENCY of 12-15 Hz in order to minimize both total I.T. and TV in order to heal the airleak.

Decrease I.T. to 30%.

ARDS

The goal is to minimize volutrauma, barotrauma and oxygen toxicity. Thus use the minimum POWER possible at the appropriate FREQUENCY in order to keep PaCO ₂ adequate (e.g. 55-65 mm Hg). Increase MAP as high as necessary to keep FiO ₂ < 1.0. Also decrease frequency to increase I.T. to improve oxygenation.

RDS

Give surfactant replacement therapy using manual bagging. Start with frequency of 15 Hz, I.T. of 33%. Use MAP of 8-10 cm or 2 cm above MAP on CMV. Wean FiO ₂ until <0.50 then MAP as tolerated to avoid over-inflation. Wean power/amplitude to keep PaCO ₂ 45-60 mmHg. Follow blood gases Q30-60 min after SRT until stable and wean appropriately to avoid hypocarbia.

Rescue Therapy For Premature Infant With RDS

To be used for premature neonates who can't ventilate on either CMV or the Infant Star HFV or who require a MAP > 20 cm to achieve oxygenation while on the Infant Star. Use initial frequency of 15 Hz, Power of 3.0 - 4.0, MAP 2 cm above MAP on the Infant Star HFV, or MAP 4 cm above the MAP on CMV.

BPD

The goal is to minimize volutrauma, barotrauma, atelectatrauma, biotrauma and oxygen toxicity. Use minimum power/amplitude to keep PaCO ₂ adequate (e.g., 50-70 mmHg). Increase MAP as necessary to keep FiO ₂<0.50 if possible. Use I.T. of 33%. Use frequency of 10-15 Hz. Use lower frequencies (6-10 Hz) if having difficulty with oxygenation or use the higher frequencies if having problems with hypocarbia or PIE.

Other Potential Indications

CHF/Pulmonary Edema, Chest Physiotherapy, Hypoplastic Lungs and Post-op Heart Patients

Not Beneficial For Asthma

Increased risk of air trapping with reactive airway disease.

WEANING

OXYGENATION

Once oxygenation is adequate and the patient is ready to be weaned follow these steps:

1) First only wean FiO2 until < 0.50-0.60 unless hyper-inflated.

2) Once FiO2 < 0.50-0.60 or hyper-inflated, decrease MAP by 1 cm Q4-8h; if OXYGENATION is lost during weaning then increase MAP by 3-4 cm to restore lung volumes and begin weaning again, but proceed more slowly with decreases in MAP.

VENTILATION

Reduce POWER by 0.2-0.3 units per change whenever PaCO2 decreases below threshold, until minimal POWER is reached (1.5-4.0) depending on the size of the patient. If frequency is below the standard frequency for the patient's weight, then first wean by increasing frequency back to baseline which also decreases the tidal volume, then decrease power as described.

1) Extubation - Most infants are ready to be extubated for a trial of NPCPAP when they meet the following criteria:

2) Conventional Ventilation - Most term neonates are ready for conversion to conventional mechanical ventilation (SIMV) when they meet the following criteria:

MAP < 16-17 cm

Power < 4.0

To convert to conventional mechanical ventilation (CMV) use a MAP 3-4 cm less than the MAP on HFV [e.g., MAP = 16-17 on HFV, use a MAP of 12-13 on CMV (PIP = 26, PEEP = 8, Rate = 40, IT = 0.4)]

COMPLICATIONS ASSOCIATED WITH HFOV

Hyperinflation or Barotrauma

Decrease MAP

Secretions

Increase frequency of suctioning

Hypotension

Decrease MAP, and rule out other causes (e.g., pneumothorax, sepsis, dehydration, etc.).
EFFECTS OF CHANGING FREQUENCY ON VENTILATION USING THE SENSORMEDICS HIGH FREQUENC OSCILLATORY VENTILATOR.

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Management Strategies with High Frequency Oscillatory Ventilation (HFOV) in Neonates Using the SensorMedics 3100A High Frequency Oscillatory Ventilator

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Jonathan M. Klein, MD Peer Review Status: Internally Peer Reviewed SensorMedics 3100A Oscillatory Ventilator The 3100A is a true high frequency oscillator with a diaphragmatically sealed piston driver. It is theoretically capable of ventilating patients up to 30 kg. Tidal volume typically delivered ≈ 1.5-3.0 cc/kg ( 35.

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International Lactation Consultant Association: World health transformed through breastfeeding and skilled lactation care.

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DVANN Website

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Delaware Valley Association of Neonatal Nurses

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7 Best TED Talks for Nurses #Nursebuff #Nurse #TED

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After working with neonates for a time, many neonatal nurses choose to take a national certification test to validate their knowledge. You may choose to be part of a neonatal transport team or participate on an extracorporeal membrane oxygenation (ECMO) team that provides heart-lung bypass for critically ill infants.

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Future of Technology for Nurse Educators

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Future of Technology for Nurse Educators

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Future of Technology in Nursing Education Part 1: The What and Why of Technology Use in Today's Nursing Student

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'The What and Why of Technology Use in Today's Nursing Student' is a four-part series that focuses on the technology today's Nursing Students are using when learning and providing patient care. Part 1 focuses the future of technology as it relates to Nursing Education.

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Illustration above shows normal circulation through heart and lungs after the baby is born.

What is persistent pulmonary hypertension in the neonate (PPHN)?

(PPHN) refers to a serious breathing problem in newborns. It usually happens in full-term babies or babies who were born at 34 weeks or more. These babies often have other types of breathing conditions.

This condition may also be known as persistent pulmonary hypertension in the newborn (PPHN) and/or persistent fetal circulation syndrome.

How does PPHN occur?

During pregnancy, the baby gets its oxygen from its mother and the placenta. Very little blood goes to the lungs because the blood vessels in the baby's lungs are mostly closed. The blood vessels only open after birth when the baby takes his or her first breaths. The vessels then allow blood to travel to the lungs to get oxygen. PPHN happens when the blood vessels do not open up enough, which means that there is a limit on how much oxygen is sent to the brain and organs. This is why PPHN is so dangerous.

What are the risk factors for PPHN?

Although the cause is unknown, certain factors increase the infant's risk of developing PPHN. These factors include:

Meconium aspiration-this happens when the baby breathes in its own sticky poop (meconium)

Infection

Respiratory distress syndrome (RDS)-this breathing difficulty happens in infants who do not have fully developed lungs

Lack of oxygen before or during birth

What causes persistent pulmonary hypertension in the neonate (PPHN)?

The cause of PPHN is not known.

In PPHN, failure of lung vessels to open enough can cause "back-pressure" and force the heart to keep using "fetal" (pre-birth) circulation pathways. These shortcuts (illustration above) ― the ductus arteriosus (DA) and the foramen ovale (FO) ― allow low-oxygen blood to mix in with blood pumped to the rest of the baby's body.

What are symptoms of PPHN?

Symptoms of PPHN include:

Breathing problems such as rapid or slow breathing, grunting, and retracting

Blue color to the skin

Hands and feet that are cool to the touch

Low blood pressure throughout the body

Low blood oxygen levels

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Persistent Pulmonary Hypertension in the Neonate (PPHN) | Cleveland Clinic Children's

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Illustration above shows normal circulation through heart and lungs after the baby is born. (PPHN) refers to a serious breathing problem in newborns. It usually happens in full-term babies or babies who were born at 34 weeks or more. These babies often have other types of breathing conditions.

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This is an example of the Bloom's Taxonomy Verb Wheel. Every level within the cognitive domain has actions and verbs that are specific to it. This chart illustrates the 6 levels, followed by the verbs that are associated with them. It then shows the different activities which students engage in, which is associated with that level. By utilizing these verbs and activities, it allows educators to address questions in such a way that students "climb the staircase" of Bloom's Taxonomy and can eventually be able to master the material.

(
http://2.bp.blogspot.com/_337GUHQH0FY/SmpJpr5va5I/AAAAAAAABmU/UFiQn59gIT8/s1600-h/bloomwheel.png)

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This is an example of the Bloom's Taxonomy Verb Wheel. Every level within the cognitive domain has actions and verbs that are specific to it. This chart illustrates the 6 levels, followed by the verbs that are associated with them. It then shows the different activities which students engage in, which is associated with that level.