Pulmonary Hypertension in Established Bronchopulmonary Dysplasia: Physiologic Approaches to Clinical Care

Steven H. Abman, Satyan Lakshminrusimha

University of Colorado Anschutz Medical Campus. University of California, Davis Children’s Hospital.
United States

Clinics in Perinatology
Clin Perinatol 2024; 51: 195-216
DOI: 10.1016/j.clp.2023.12.002

Abstract
Preterm infants with bronchopulmonary dysplasia (BPD) are prone to develop pulmonary hypertension (PH). Strong laboratory and clinical data suggest that antenatal factors, such as preeclampsia, chorioamnionitis, oligohydramnios, and placental dysfunction leading to fetal growth restriction, increase susceptibility for BPD-PH after premature birth. Echocardiogram metrics and serial assessments of NT-proBNP provide useful tools to diagnose and monitor clinical course during the management of BPD-PH, as well as monitoring for such complicating conditions as left ventricular diastolic dysfunction, shunt lesions, and pulmonary vein stenosis. Therapeutic strategies should include careful assessment and management of underlying airways and lung disease, cardiac performance, and systemic hemodynamics, prior to initiation of PH-targeted drug therapies.

Category
Stenosis or Obstruction of Normal Pulmonary Venous Connections
Patient Factors Influencing the Onset, Severity or Outcome of Disease

Year of Publication: 2024

Age Focus: Pediatric

Article Type: Review

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