Pulmonary hypertension in a neonatologist-performed echocardiographic follow-up of bronchopulmonary dysplasia
| Autor: | Luigi Castriotta, Francesca Rech Morassutti, Paola Freschi, Daisy Pavoni, Marilena Savoia, Luigi Cattarossi, Peter M. Mourani, Antonio Tonutti |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
medicine.medical_specialty Hypertension Pulmonary Birth weight Gestational Age 03 medical and health sciences 0302 clinical medicine Neonatologists 030225 pediatrics Internal medicine Intensive care medicine Humans Outpatient clinic 030212 general & internal medicine Neonatology Child Bronchopulmonary Dysplasia Retrospective Studies business.industry Infant Newborn Postmenstrual Age Infant Gestational age medicine.disease Pulmonary hypertension Bronchopulmonary dysplasia Echocardiography Pediatrics Perinatology and Child Health Cardiology business Infant Premature Follow-Up Studies |
| Zdroj: | European Journal of Pediatrics. 180:1711-1720 |
| ISSN: | 1432-1076 0340-6199 |
| DOI: | 10.1007/s00431-021-03954-y |
| Popis: | Neonatologist-performed echocardiography (NPE) is an established tool for bedside hemodynamic evaluation, including pulmonary hypertension (PH). PH may complicate bronchopulmonary dysplasia (BPD) course. Aims of this retrospective study were to assess the feasibility of NPE follow-up of infants with BPD and to describe the course of PH of infants with moderate/severe BPD. Preterm infants32 gestational weeks or birthweight ≤1500 g with moderate/severe BPD underwent NPE follow-up, from 36 weeks postmenstrual age up to 8 months postnatal age. Twenty-three preemies were included (birth weight 840 (213) g, gestational age 26.8 (2.3) weeks); 12/23 developed mild PH, 2/12 after discharge. PH resolved at 8.9 (3.9) months. Clinical and echocardiographic variables did not differ between infants with and without PH, except pulmonary artery acceleration time (PAAT) and PAAT/right ventricle ejection time (RVET) ratio (PAAT: 36 weeks, 68.9 (11.9) vs 52.0 (19.1), p = 0.0443; 6 months: 83.9 (38.9) vs 74.8 (16.9), p = 0.0372). No deaths or admissions for PH were reported. Neonatologist's Image Quality Assessment score attributed by the cardiologist assumed as gold standard was adequate or optimal (9.5/14 total score); inter-rater agreement was excellent (ICC 0.974).Conclusions: NPE follow-up seems to be feasible and safe in both intensive care and outpatient clinic. Mild PH is frequently detected in moderate/severe BPD, with good prognosis. What is Known: • Preterm infants with bronchopulmonary dysplasia (BPD) may develop pulmonary hypertension (PH) and have a late diagnosis. • Neonatologist-performed echocardiography (NPE) is an established tool for bedside hemodynamic evaluation of the neonate. What is New: • To our knowledge this is the first study of NPE follow-up of moderate/severe BPD, describing the course of mild PH from diagnosis to its resolution. • NPE follow-up of BPD seems to be safe and practicable, in both intensive care and outpatient clinic, as long as neonatologists maintain a sound collaboration with pediatric cardiologists. |
| Databáze: | OpenAIRE |
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