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

Gabriel Altit, Henry C. Lee, Susan Hintz, Theresa A. Tacy, Jeffrey A. Feinstein, Shazia Bhombal

Montreal Children’s Hospital and McGill University. Stanford University and Lucile Packard Children’s Hospital.
Canada and United States

Journal of Perinatology
J Perinatol 2018; 38: 361-367
DOI: 10.1038/s41372-017-0025-3

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.

Category
Stenosis or Obstruction of Normal Pulmonary Venous Connections
Pulmonary Hypertension Associated with Stenosis or Atresia of Pulmonary Veins
Incidence or Prevalence of Disease
Patient Factors Influencing the Onset, Severity or Outcome of Disease

Year of Publication: 2018

Age Focus: Pediatric

Article Type: Surveys of Health Care Providers

Article Access: Free PDF File or Full Text Article Available Through PubMed or DOI: No