Abstract
With the increasing survival of preterm infants, pulmonary hypertension (PH) related to bronchopulmonary dysplasia (BPD) has become an important complication. The aim of this study was to investigate the characteristics and outcome of PH in preterm infants with BPD and to identify the risk factors for PH. We reviewed the records of 116 preterm infants with BPD cared for at a single tertiary center between 2004 and 2008. Twenty-nine (25%) infants had PH >2 months after birth. PH occurred initially at a median age of 65 days (range, 7-232 days). Severe BPD, a birth weight <800 g, long-term ventilator care and oxygen supplementation, a high ventilator setting, infection, and a patent ductus arteriosus (PDA) were related to PH based on univariate analysis (p<0.05). The infants who had longer oxygen supplementation were significantly more likely to have PH (odds ratio, 18.5; 95% confidence interval, 4.1-84.6; p<0.001). PH was improved in 76% of infants after a median of 85 days (range, 20-765 days). Four infants (14%) died. The death of 3 infants was attributed to PH. BPD was frequently complicated by PH. Although PH resolved in the majority of infants, PH in preterm infants with BPD can be fatal. Regular screening for PH and adequate management are required.
Keywords
Bronchopulmonary dysplasia
Hypertension
pulmonary
Infant
premature
Authors & Affiliations
10 authors, click to expand affiliations / ORCID
An Hyo Soon
Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea.
Bae Eun Jung
Kim Gi Beom
Kwon Bo Sang
Beak Jae Suk
Kim Ee Kyung
Kim Han Suk
Choi Jung-Hwan
Noh Chung Il
Yun Yong Soo
References (15)
15 references, click to expand
-
Pulmonary hypertension in infants with bronchopulmonary dysplasia.
J Pediatr. 1988 Jan;112(1):67-72
PMID: 3335964
-
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
PMID: 18055675
-
Bronchopulmonary dysplasia.
Am J Respir Crit Care Med. 2001 Jun;163(7):1723-9
PMID: 11401896
-
Definitions and diagnostic criteria for bronchopulmonary dysplasia.
Semin Perinatol. 2006 Aug;30(4):164-70
PMID: 16860155
-
Clinical utility of echocardiography for the diagnosis and management of pulmonary vascular disease in young children with chronic lung disease.
Pediatrics. 2008 Feb;121(2):317-25
PMID: 18245423
-
Recent advances in diagnosis and management of pulmonary hypertension in chronic lung disease.
Acta Paediatr Suppl. 2004 Feb;93(444):29-32
PMID: 15035460
-
Pulmonary arterial hypertension: the key role of echocardiography.
Chest. 2005 May;127(5):1836-43
PMID: 15888866
-
Evaluation of infants with bronchopulmonary dysplasia using cardiac catheterization.
Pediatrics. 1982 Nov;70(5):708-12
PMID: 7133822
-
Value of echocardiography in assessing the outcome of bronchopulmonary dysplasia of the newborn.
Pediatrics. 1980 Mar;65(3):529-35
PMID: 7360540
-
Pulmonary vascular response to oxygen in infants with severe bronchopulmonary dysplasia.
Pediatrics. 1985 Jan;75(1):80-4
PMID: 3838113
-
Lung vascular development: implications for the pathogenesis of bronchopulmonary dysplasia.
Annu Rev Physiol. 2005;67:623-61
PMID: 15709973
-
Unsuspected cardiopulmonary abnormalities complicating bronchopulmonary dysplasia.
Arch Dis Child. 1984 Oct;59(10):966-70
PMID: 6238574
-
Pulmonary arterial hypertension in the pediatric age.
J Cardiovasc Med (Hagerstown). 2007 Jan;8(1):72-7
PMID: 17255821
-
Pulmonary artery pressure changes in the very low birthweight infant developing chronic lung disease.
Arch Dis Child. 1993 Mar;68(3 Spec No):303-7
PMID: 8466267
-
Pulmonary vascular effects of inhaled nitric oxide and oxygen tension in bronchopulmonary dysplasia.
Am J Respir Crit Care Med. 2004 Nov 1;170(9):1006-13
PMID: 15184202