Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Mar;129(3):e682-9.
doi: 10.1542/peds.2011-1827. Epub 2012 Feb 6.

Prospective analysis of pulmonary hypertension in extremely low birth weight infants

Ramachandra Bhat  1 , Ariel A Salas, Chris Foster, Waldemar A Carlo, Namasivayam Ambalavanan
Affiliations

Prospective analysis of pulmonary hypertension in extremely low birth weight infants

Ramachandra Bhat et al. Pediatrics. 2012 Mar.

Abstract

Objectives: Pulmonary hypertension is associated with bronchopulmonary dysplasia in extremely low birth weight (ELBW) infants and contributes to morbidity and mortality. The objective was to determine the prevalence of pulmonary hypertension among ELBW infants by screening echocardiography and evaluate subsequent outcomes.

Methods: All ELBW infants admitted to a regional perinatal center were evaluated for pulmonary hypertension with echocardiography at 4 weeks of age and subsequently if clinical signs suggestive of right-sided heart failure or severe lung disease were evident. Management was at discretion of the clinician, and infants were evaluated until discharge from the hospital or pre-discharge death occurred.

Results: One hundred forty-five ELBW infants (birth weight: 755 ± 144 g; median gestational age: 26 weeks [interquartile range: 24-27]) were screened from December 2008 to February 2011. Overall, 26 (17.9%) were diagnosed with pulmonary hypertension at any time during hospitalization (birth weight: 665 ± 140 g; median gestational age: 26 weeks [interquartile range: 24-27]): 9 (6.2%) by initial screening (early pulmonary hypertension) and 17 (11.7%) who were identified later (late pulmonary hypertension). Infants with pulmonary hypertension were more likely to receive oxygen treatment on day 28 compared with those without pulmonary hypertension (96% vs 75%, P < .05). Of the 26 infants, 3 died (all in the late group because of cor pulmonale) before being discharged from the hospital.

Conclusions: Pulmonary hypertension is relatively common, affecting at least 1 in 6 ELBW infants, and persists to discharge in most survivors. Routine screening of ELBW infants with echocardiography at 4 weeks of age identifies only one-third of the infants diagnosed with pulmonary hypertension. Further research is required to determine optimal detection and intervention strategies.

PubMed Disclaimer

Figures

FIGURE 1
FIGURE 1
Flowchart of infants evaluated in the study. O2, oxygen; Spo2, pulse oximeter oxygen saturation.
See this image and copyright information in PMC

References

    1. Stoll BJ, Hansen NI, Bell EF, et al. Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network. Pediatrics. 2010;126(3):443–456 - PMC - PubMed
    1. Subhedar NV. Recent advances in diagnosis and management of pulmonary hypertension in chronic lung disease. Acta Paediatr Suppl. 2004;93(444):29–32 - PubMed
    1. Abman SH. Monitoring cardiovascular function in infants with chronic lung disease of prematurity. Arch Dis Child Fetal Neonatal Ed. 2002;87(1):F15–F18 - PMC - PubMed
    1. Gorenflo M, Vogel M, Obladen M. Pulmonary vascular changes in bronchopulmonary dysplasia: a clinicopathologic correlation in short- and long-term survivors. Pediatr Pathol. 1991;11(6):851–866 - PubMed
    1. Stenmark KR, Abman SH. Lung vascular development: implications for the pathogenesis of bronchopulmonary dysplasia. Annu Rev Physiol. 2005;67:623–661 - PubMed

Publication types

MeSH terms