G Al-Ghanem1, P Shah2, S Thomas3, L Banfield1, S El Helou1, C Fusch1, A Mukerji1. 1. Department of Pediatrics, McMaster University, Hamilton, ON, Canada. 2. Department of Pediatrics, University of Toronto, Toronto, ON, Canada. 3. Department of Pediatrics, University of Calgary, Calgary, AB, Canada.
Abstract
OBJECTIVE: Pulmonary hypertension (PH) is a complication of bronchopulmonary dysplasia (BPD) but the true impact of PH in patients with BPD remains unclear. We sought to systematically review and meta-analyze incidence of PH in BPD and compare clinical outcomes of BPD patients with PH to those without PH in preterm infants. STUDY DESIGN: Medline, Embase, PsychINFO and CINAHL were searched from January 2000 through December 2015. Cohort, case-control and randomized studies were included. Case-reports, case-series and letters to editors and studies with high risk of bias were excluded. Study design, inclusion/exclusion criteria, diagnostic criteria for BPD and PH and outcomes were extracted independently by two co-authors. RESULTS: The pooled incidence of PH in patients with BPD (any severity) was 17% (95% confidence interval (CI) 12 to 21; 7 studies) and 24% (95% CI 17 to 30; 9 studies) in moderate-severe BPD. Patients with BPD have higher unadjusted odds of developing PH compared to those without BPD (odds ratio (OR) 3.00; 95% CI 1.18 to 7.66; 4 studies). Patients with BPD and PH were at higher odds of mortality (OR 5.29; 95% CI 2.07 to 13.56; 3 studies) compared with BPD without PH, but there was no significant difference in duration of initial hospitalization, duration of supplemental oxygen requirement or need for home oxygen. No studies included in this review reported on long-term pulmonary or neurodevelopmental outcomes. CONCLUSIONS: PH occurs in one out of 4 to 5 preterm neonates with BPD. Patients with BPD and PH may have higher odds of mortality; however, there is urgent need for high quality studies that control for confounders and provide data on long-term outcomes.
OBJECTIVE:Pulmonary hypertension (PH) is a complication of bronchopulmonary dysplasia (BPD) but the true impact of PH in patients with BPD remains unclear. We sought to systematically review and meta-analyze incidence of PH in BPD and compare clinical outcomes of BPD patients with PH to those without PH in preterm infants. STUDY DESIGN: Medline, Embase, PsychINFO and CINAHL were searched from January 2000 through December 2015. Cohort, case-control and randomized studies were included. Case-reports, case-series and letters to editors and studies with high risk of bias were excluded. Study design, inclusion/exclusion criteria, diagnostic criteria for BPD and PH and outcomes were extracted independently by two co-authors. RESULTS: The pooled incidence of PH in patients with BPD (any severity) was 17% (95% confidence interval (CI) 12 to 21; 7 studies) and 24% (95% CI 17 to 30; 9 studies) in moderate-severe BPD. Patients with BPD have higher unadjusted odds of developing PH compared to those without BPD (odds ratio (OR) 3.00; 95% CI 1.18 to 7.66; 4 studies). Patients with BPD and PH were at higher odds of mortality (OR 5.29; 95% CI 2.07 to 13.56; 3 studies) compared with BPD without PH, but there was no significant difference in duration of initial hospitalization, duration of supplemental oxygen requirement or need for home oxygen. No studies included in this review reported on long-term pulmonary or neurodevelopmental outcomes. CONCLUSIONS: PH occurs in one out of 4 to 5 preterm neonates with BPD. Patients with BPD and PH may have higher odds of mortality; however, there is urgent need for high quality studies that control for confounders and provide data on long-term outcomes.
Authors: Peter M Mourani; Marci K Sontag; Adel Younoszai; Joshua I Miller; John P Kinsella; Christopher D Baker; Brenda B Poindexter; David A Ingram; Steven H Abman Journal: Am J Respir Crit Care Med Date: 2015-01-01 Impact factor: 21.405
Authors: Monique E De Paepe; Sharon Chu; Susan J Hall; Elizabeth McDonnell-Clark; Nicholas E Heger; Christoph Schorl; Quanfu Mao; Kim Boekelheide Journal: Exp Lung Res Date: 2015 Impact factor: 2.459
Authors: Hyo Soon An; Eun Jung Bae; Gi Beom Kim; Bo Sang Kwon; Jae Suk Beak; Ee Kyung Kim; Han Suk Kim; Jung-Hwan Choi; Chung Il Noh; Yong Soo Yun Journal: Korean Circ J Date: 2010-03-24 Impact factor: 3.243
Authors: J K Trittmann; L D Nelin; E J Zmuda; J M Gastier-Foster; B Chen; C H Backes; J Frick; P Vaynshtok; V J Vieland; M A Klebanoff Journal: Acta Paediatr Date: 2014-07-06 Impact factor: 2.299
Authors: Barbara J Stoll; Nellie I Hansen; Edward F Bell; Michele C Walsh; Waldemar A Carlo; Seetha Shankaran; Abbot R Laptook; Pablo J Sánchez; Krisa P Van Meurs; Myra Wyckoff; Abhik Das; Ellen C Hale; M Bethany Ball; Nancy S Newman; Kurt Schibler; Brenda B Poindexter; Kathleen A Kennedy; C Michael Cotten; Kristi L Watterberg; Carl T D'Angio; Sara B DeMauro; William E Truog; Uday Devaskar; Rosemary D Higgins Journal: JAMA Date: 2015-09-08 Impact factor: 56.272
Authors: Ekta Khemani; Doff B McElhinney; Lawrence Rhein; Olyn Andrade; Ronald V Lacro; Kristin C Thomas; Mary P Mullen Journal: Pediatrics Date: 2007-12 Impact factor: 7.124
Authors: Jennifer L Cohen; Shannon N Nees; Gerson A Valencia; Erika B Rosenzweig; Usha S Krishnan Journal: J Pediatr Date: 2018-11-02 Impact factor: 4.406
Authors: Saima Ahmed; Oludare A Odumade; Patrick van Zalm; Kinga K Smolen; Kimino Fujimura; Jan Muntel; Melissa S Rotunno; Abigail B Winston; Judith A Steen; Richard B Parad; Linda J Van Marter; Stella Kourembanas; Hanno Steen Journal: Neonatology Date: 2022-01-24 Impact factor: 4.035
Authors: Aline B Maddux; Peter M Mourani; Russell Banks; Ron W Reeder; Murray M Pollack; Robert A Berg; Kathleen L Meert; Patrick S McQuillen; Andrew R Yates; Daniel A Notterman; John T Berger Journal: Respir Care Date: 2021-10 Impact factor: 2.339
Authors: Gareth R Willis; Monica Reis; Ali Hashemi Gheinani; Angeles Fernandez-Gonzalez; Elizabeth S Taglauer; Vincent Yeung; Xianlan Liu; Maria Ericsson; Eric Haas; S Alex Mitsialis; Stella Kourembanas Journal: Am J Respir Crit Care Med Date: 2021-12-15 Impact factor: 21.405
Authors: Karan R Kumar; David A Clark; Evan M Kim; Jasmine D Perry; Kaylyn Wright; Sheikisha A Thomas; Elizabeth J Thompson; Rachel G Greenberg; P Brian Smith; Daniel K Benjamin; Matthew M Laughon; Reese H Clark; Christoph P Hornik Journal: J Pediatr Date: 2018-08-29 Impact factor: 6.314
Authors: Hyun Ho Kim; Se In Sung; Mi Sun Yang; Yea Seul Han; Hye Seon Kim; So Yoon Ahn; Ga Won Jeon; Yun Sil Chang; Won Soon Park Journal: Sci Rep Date: 2021-05-27 Impact factor: 4.379