Korean Circ J.  2010 Mar;40(3):131-136. 10.4070/kcj.2010.40.3.131.

Pulmonary Hypertension in Preterm Infants With Bronchopulmonary Dysplasia

• An HS
• Bae EJ
• Kim GB
• Kwon BS
• Beak JS
• Kim EK
• Kim HS
• Choi JH
• Noh CI
• Yun YS

• KMID: 2094073
• DOI: http://doi.org/10.4070/kcj.2010.40.3.131

Abstract

BACKGROUND AND OBJECTIVES
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. SUBJECTS AND METHODS: We reviewed the records of 116 preterm infants with BPD cared for at a single tertiary center between 2004 and 2008. RESULTS: 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. CONCLUSION: 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.

Keyword

Hypertension, pulmonary; Infant, premature; Bronchopulmonary dysplasia

MeSH Terms

Birth Weight
Bronchopulmonary Dysplasia
Ductus Arteriosus, Patent
Humans
Hydrogen-Ion Concentration
Hypertension, Pulmonary
Infant
Infant, Newborn
Infant, Premature
Mass Screening
Oxygen
Parturition
Risk Factors
Ventilators, Mechanical
Oxygen

Figure

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  Fig. 1 The occurrence of PH with the degree of BPD severity. The occurrence of PH positively correlated with the degree of BPD severity (p<0.001). PH: pulmonary hypertension, BPD: bronchopulmonary dysplasia.

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  Fig. 2 Kaplan-Meier curve express the resolution of PH. PH improved in 68% of patients by 6 months and 73% of patients by 1 year. PH: pulmonary hypertension.

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