Gabriel Altit1,2, Henry C Lee3, Susan Hintz4, Theresa A Tacy5, Jeffrey A Feinstein6, Shazia Bhombal3. 1. Neonatology, Montreal Children's Hospital, McGill University, Montreal, QC, Canada. gabriel.altit@mail.mcgill.ca. 2. Pediatric Cardiology and Neonatal and Developmental Medicine at Stanford University, Lucile Packard Children's Hospital, Palo Alto, CA, USA. gabriel.altit@mail.mcgill.ca. 3. Neonatal and Developmental Medicine, Stanford University, Lucile Packard Children's Hospital, Palo Alto, CA, USA. 4. Obstetrics and Gynecology, Neonatologist, Professor in Neonatal and Developmental Medicine, Stanford University, Lucile Packard Children's Hospital, Palo Alto, CA, USA. 5. Echocardiography Laboratory, Stanford University, Lucile Packard Children's Hospital, Palo Alto, CA, USA. 6. Bioengineering, Pediatric Cardiologist, Stanford University, Lucile Packard Children's Hospital, Palo Alto, CA, USA.
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.
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.
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