Journal article
Short and long-term outcomes of chronic pulmonary hypertension in preterm infants managed using a standardized algorithm
Pediatric pulmonology, Vol.56(5), pp.1155-1164
05/2021
DOI: 10.1002/ppul.25200
PMID: 33270376
Abstract
There is limited data on management strategies for chronic pulmonary hypertension (cPH) in chronic lung disease (CLD) of prematurity. Our objective was to evaluate clinical outcomes following a standardized policy, wherein only cPH with right-ventricular (RV) dilatation was treated and diuretics were employed as first-line therapy; cPH without RV-dilatation was managed expectantly.
In this retrospective cohort study, all infants with CLD were categorized as "CLD-only" or "CLD-cPH," using echocardiography at ≥36 weeks postmenstrual age. Intergroup comparison was performed. Regression analysis examined the association between cPH and primary outcome of death or disability at 18-24 months.
Of 128 CLD infants, 48 (38%) had cPH, of which 29 (60%) received diuretics. Symptomatic improvement within 1-week was recorded in 90%. Although CLD-cPH had worse in-hospital respiratory course than CLD-only, all post-discharge respiratory and neurodevelopmental outcomes were similar. cPH was not associated with death or disability (adjusted odds ratio, 1.02; 95% confidence interval, 0.32-3.27). Disease progression treated with sildenafil occurred in 2 (4%) cases. There was no death from respiratory or RV failure.
Primary treatment of CLD-cPH with diuretics using RV-dilatation as therapeutic threshold, may result in symptomatic improvement, disease stabilization and post-discharge outcomes comparable to infants without cPH.
Details
- Title: Subtitle
- Short and long-term outcomes of chronic pulmonary hypertension in preterm infants managed using a standardized algorithm
- Creators
- Michelle Baczynski - Mount Sinai HospitalEdmond Kelly - Mount Sinai HospitalPatrick J McNamara - University of IowaPrakesh S Shah - University of TorontoAmish Jain - Mount Sinai Hospital
- Resource Type
- Journal article
- Publication Details
- Pediatric pulmonology, Vol.56(5), pp.1155-1164
- DOI
- 10.1002/ppul.25200
- PMID
- 33270376
- ISSN
- 8755-6863
- eISSN
- 1099-0496
- Language
- English
- Date published
- 05/2021
- Academic Unit
- Stead Family Department of Pediatrics; Neonatology; Internal Medicine
- Record Identifier
- 9984354007602771
Metrics
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