缺氧性肺血管收缩
氧化应激
医学
高氧
一氧化氮
活性氧
肺动脉高压
缺氧(环境)
低氧血症
抗氧化剂
血管舒张
充氧
通风(建筑)
内皮功能障碍
药理学
麻醉
氧气
心脏病学
内科学
肺
生物化学
生物
化学
机械工程
有机化学
工程类
作者
Munmun Rawat,Satyan Lakshminrusimha,Máximo Vento
标识
DOI:10.1016/j.siny.2022.101347
摘要
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 PaO2 in these models, but clinical trials are lacking. We recommend targeting preductal SpO2 between 90 and 97%, PaO2 between 55 and 80 mmHg and avoiding FiO2 > 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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