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<p><b>New page</b></p><div>__NOTOC__<br />
A full-term neonate develops cyanosis in the newborn nursery and is<br />
transferred to the NICU. The infant is not in respiratory distress, and the chest xray<br />
is normal. 100% FiO2 via oxygen hood fails to correct the hypoxemia. PPHN is<br />
suspected and an echocardiogram is ordered. Choose the BEST statement:<br />
<br />
a) Based on the presentation, diaphragmatic hernia is the likely cause of PPHN in<br />
this infant<br />
<br />
b) Echocardiogram likely shows bowing of the ventricular septum into the right<br />
ventricle, consistent with elevated PVR<br />
<br />
c) Hypoxemia despite 20 ppm of inhaled NO is an indication to initiate ECMO<br />
<br />
d) Infants with PPHN requiring ECMO have an approximately 85% mortality rate<br />
<br />
e) A serum blood glucose should be checked because hypoglycemia predisposes<br />
infants to PPHN<br />
<div class="mw-customtoggle-TYK_Answer" style="text-align: right; color:#0000ff">Click for Answer</div><br />
<div class="mw-collapsible mw-collapsed" id="mw-customcollapsible-TYK_Answer"><br />
==Answer==<br />
Answer e. Hypoglycemia predisposes to PPHN, and patients with unexplained<br />
hypoxemia should have glucose checked to rule this out. Mortality for patients<br />
with PPHN requiring ECMO is lower than other patient groups utilizing ECMO.<br />
Echocardiography will likely show bowing of the ventricular septum towards the<br />
left.<br />
==Notes==<br />
<references /><br />
:This question originally printed in the [http://www.amazon.com/Justin-L.-Lockman/e/B00FLG5AEE/ref=ntt_dp_epwbk_0 Pediatric Anesthesiology Review Topics] kindle book series, and appears courtesy of Naerthwyn Press, LLC.<br />
==Keywords==<br />
:<br />
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