Practices surrounding pulmonary hypertension and bronchopulmonary dysplasia amongst neonatologists caring for premature infants

J Perinatol. 2018 Apr;38(4):361-367. doi: 10.1038/s41372-017-0025-3. Epub 2017 Dec 12.

Abstract

Objective: Pulmonary hypertension (PH) is associated with bronchopulmonary dysplasia (BPD). Screening strategies, a thorough investigation of co-morbidities, and multidisciplinary involvement prior to anti-PH medications have been advocated by recent guidelines. We sought to evaluate current practices of neonatologists caring for premature infants with PH.

Design: Electronic survey of American Academy of Pediatrics neonatology members.

Results: Among 306 neonatologist respondents, 38% had an institutional screening protocol for patients with BPD; 83% screened at 36 weeks for premature neonates on oxygen/mechanical ventilation. In those practicing more than 5 years, 54% noted increasing numbers of premature infants diagnosed with PH. Evaluation for PH in BPD patients included evaluations for micro-aspiration (41%), airways anomalies (29%), and catheterization (10%). Some degree of acquired pulmonary vein stenosis was encountered in 47%. A majority (90%) utilized anti-PH medications during the neonatal hospitalization.

Conclusions: Screening for PH in BPD, and subsequent evaluation and management is highly variable.

MeSH terms

  • Bronchopulmonary Dysplasia / complications*
  • Bronchopulmonary Dysplasia / diagnosis
  • Bronchopulmonary Dysplasia / therapy
  • Humans
  • Hypertension, Pulmonary / diagnosis*
  • Hypertension, Pulmonary / etiology
  • Hypertension, Pulmonary / therapy
  • Infant
  • Infant, Newborn
  • Infant, Premature*
  • Neonatal Screening / methods*
  • Neonatologists / statistics & numerical data*
  • Oxygen Inhalation Therapy
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Respiration, Artificial