Ruth B Seabrook1, Theresa R Grover2, Natalie Rintoul3, Mark Weems4, Sarah Keene5, Beverly Brozanski6, Robert DiGeronimo7, Beth Haberman8, Holly Hedrick3, Jason Gien2, Noorjahan Ali9, Rachel Chapman10, John Daniel11, H Allen Harrison12, Yvette Johnson13, Nicolas F M Porta14, Michael Uhing15, Isabella Zaniletti16, Karna Murthy14. 1. Nationwide Children's Hospital and the Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA. Ruth.Seabrook@nationwidechildrens.org. 2. Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, CO, USA. 3. Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA. 4. LeBonheur Children's Hospital and the University of Tennessee Health Science Center, Memphis, TN, USA. 5. Children's Healthcare of Atlanta at Egleston, Emory Children's Pediatric Institute, and Emory University School of Medicine, Atlanta, GA, USA. 6. St Louis Children's Hospital and the Department of Pediatrics, Washington University School of Medicine, St Louis, MO, USA. 7. Seattle Children's Hospital and University of Washington, Seattle, WA, USA. 8. Cincinnati Children's Hospital Medical Center and University of Cincinnati School of Medicine, Cincinnati, OH, USA. 9. University of Texas Southwestern, Dallas, TX, USA. 10. Children's Hospital Los Angeles and the Fetal & Neonatal Institute, Department of Pediatrics. USC Keck School of Medicine, Los Angeles, CA, USA. 11. Children's Mercy Hospitals & Clinics, Department of Pediatrics, University of Missouri Kansas City School of Medicine, Kansas City, MO, USA. 12. Arkansas Children's Hospital, Little Rock, AR, USA. 13. Cook Children's Hospital, Fort Worth, TX, USA. 14. Ann & Robert H Lurie Children's Hospital of Chicago and the Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. 15. Children's Hospital of Wisconsin and Medical College of Wisconsin, Milwaukee, WI, USA. 16. Children's Hospital Association, Inc, Lenexa, KS, USA.
Abstract
OBJECTIVE: Describe inpatient pulmonary hypertension (PH) treatment and factors associated with therapy at discharge in a multicenter cohort of infants with CDH. METHODS: Six years linked records from Children's Hospitals Neonatal Database and Pediatric Health Information System were used to describe associations between prenatal/perinatal factors, clinical outcomes, echocardiographic findings and PH medications (PHM), during hospitalization and at discharge. RESULTS: Of 1106 CDH infants from 23 centers, 62.8% of infants received PHM, and 11.6% of survivors were discharged on PHM. Survivors discharged on PHM more frequently had intrathoracic liver, small for gestational age, and low 5 min APGARs compared with those discharged without PHM (p < 0.0001). Nearly one-third of infants discharged without PHM had PH on last inpatient echo. CONCLUSIONS: PH medication use is common in CDH. Identification of infants at risk for persistent PH may impact ongoing management. Post-discharge follow-up of all CDH infants with echocardiographic evidence of PH is warranted.
OBJECTIVE: Describe inpatient pulmonary hypertension (PH) treatment and factors associated with therapy at discharge in a multicenter cohort of infants with CDH. METHODS: Six years linked records from Children's Hospitals Neonatal Database and Pediatric Health Information System were used to describe associations between prenatal/perinatal factors, clinical outcomes, echocardiographic findings and PH medications (PHM), during hospitalization and at discharge. RESULTS: Of 1106 CDH infants from 23 centers, 62.8% of infants received PHM, and 11.6% of survivors were discharged on PHM. Survivors discharged on PHM more frequently had intrathoracic liver, small for gestational age, and low 5 min APGARs compared with those discharged without PHM (p < 0.0001). Nearly one-third of infants discharged without PHM had PH on last inpatient echo. CONCLUSIONS: PH medication use is common in CDH. Identification of infants at risk for persistent PH may impact ongoing management. Post-discharge follow-up of all CDH infants with echocardiographic evidence of PH is warranted.
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