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Review
. 2016 Jun;28(3):324-30.
doi: 10.1097/MOP.0000000000000355.

Pulmonary hypertension in the premature infant: a challenging comorbidity in a vulnerable population

Michael Glenn O'Connor  1 , David N Cornfield, Eric D Austin
Affiliations
Review

Pulmonary hypertension in the premature infant: a challenging comorbidity in a vulnerable population

Michael Glenn O'Connor et al. Curr Opin Pediatr. 2016 Jun.

Abstract

Purpose of review: This review is written from the perspective of the pediatric clinician involved in the care of premature infants at risk for pulmonary hypertension. The main objective is to better inform the clinician in the diagnosis and treatment of pulmonary hypertension in premature infants by reviewing the available relevant literature and focusing on the areas for which there is the greatest need for continued research.

Recent findings: Continued knowledge regarding the epidemiology of pulmonary hypertension in the premature infant population has aided better diagnostic screening algorithms. Included in this knowledge, is the association of pulmonary hypertension in infants with bronchopulmonary dysplasia (BPD). However, it is also known that beyond BPD, low birth weight and other conditions that result in increased systemic inflammation are associated with pulmonary hypertension. This information has led to the recent recommendation that all infants with BPD should have an echocardiogram to evaluate for evidence of pulmonary hypertension prior to discharge from the neonatal ICU.

Summary: Pulmonary hypertension can be a significant comorbidity for premature infants. This review aims to focus the clinician on the available literature to improve recognition of the condition to allow for more timely interventions.

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Figures

Figure 1
Figure 1
Risk factors for pulmonary hypertension in the premature infant population, and potential opportunities for treatment intervention and areas for further research.
See this image and copyright information in PMC

References

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    1. Khemani E, McElhinney DB, Rhein L, Andrade O, Lacro RV, Thomas KC, et al. Pulmonary artery hypertension in formerly premature infants with bronchopulmonary dysplasia: clinical features and outcomes in the surfactant era. Pediatrics. 2007 Dec;120(6):1260–9. PubMed PMID: 18055675. Epub 2007/12/07. eng. This retrospective case-series of 42 premature infants from 1998-2006 is one of the initial manuscripts to describe PH in the setting of a more modern BPD population. This manuscript includes hemodynamic parameters and survival data of the premature infants who developed pulmonary hypertension.

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