Pulmonary Hypertension and Oxidative Stress: Where is the Link?

Overview

Journal Semin Fetal Neonatal Med

Publisher Elsevier

Specialties Gynecology & Obstetrics
Pediatrics

Date 2022 Apr 27

PMID 35473693

Authors

Munmun Rawat

Satyan Lakshminrusimha

Maximo Vento

Affiliations

Soon will be listed here.

Abstract

Oxidative stress can be associated with hyperoxia and hypoxia and is characterized by an increase in reactive oxygen (ROS) and nitrogen (RNS) species generated by an underlying disease process or by supplemental oxygen that exceeds the neutralization capacity of the organ system. ROS and RNS acting as free radicals can inactive several enzymes and vasodilators in the nitric oxide pathway promoting pulmonary vasoconstriction resulting in persistent pulmonary hypertension of the newborn (PPHN). Studies in animal models of PPHN have shown high ROS/RNS that is further increased by hyperoxic ventilation. In addition, antioxidant therapy increased PaO in these models, but clinical trials are lacking. We recommend targeting preductal SpO between 90 and 97%, PaO between 55 and 80 mmHg and avoiding FiO > 0.6-0.8 if possible during PPHN management. This review highlights the role of oxidative and nitrosative stress markers on PPHN and potential therapeutic interventions that may alleviate the consequences of increased oxidant stress during ventilation with supplemental oxygen.

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