AIM: To determine if pulmonary artery pressure (PAP) in ventilated preterm infants is independently associated with the development of chronic lung disease (CLD) and whether early assessment has any prognostic value. METHODS: Two cohorts (development n = 55; and validation n = 28) of preterm infants were studied at 24 hours of age. PAP was assessed non-invasively using its inverse correlation with the corrected acceleration time to right ventricular ejection time ratio (AT:RVET(c)), calculated from the pulmonary artery Doppler waveform. Clinical and respiratory variables were also collected. Using logistic regression analysis to identify factors independently associated with CLD, a prognostic score was developed to predict CLD. The ability of the score to predict CLD was described using receiver operating characteristic (ROC) curves. RESULTS: Birthweight, inspired oxygen concentration, and AT:RVET(c) were independently predictive of CLD. The area under the ROC curve was 0.96 for the development and 0.89 for the validation cohort. Exclusion of AT:RVET(c) resulted in a reduction to 0.88 and 0.73, respectively. CONCLUSION: PAP is independently associated with CLD. An early assessment of PAP using AT:RVET(c) may permit the early prediction of CLD as part of a multifactorial scoring system.
AIM: To determine if pulmonary artery pressure (PAP) in ventilated preterm infants is independently associated with the development of chronic lung disease (CLD) and whether early assessment has any prognostic value. METHODS: Two cohorts (development n = 55; and validation n = 28) of preterm infants were studied at 24 hours of age. PAP was assessed non-invasively using its inverse correlation with the corrected acceleration time to right ventricular ejection time ratio (AT:RVET(c)), calculated from the pulmonary artery Doppler waveform. Clinical and respiratory variables were also collected. Using logistic regression analysis to identify factors independently associated with CLD, a prognostic score was developed to predict CLD. The ability of the score to predict CLD was described using receiver operating characteristic (ROC) curves. RESULTS: Birthweight, inspired oxygen concentration, and AT:RVET(c) were independently predictive of CLD. The area under the ROC curve was 0.96 for the development and 0.89 for the validation cohort. Exclusion of AT:RVET(c) resulted in a reduction to 0.88 and 0.73, respectively. CONCLUSION: PAP is independently associated with CLD. An early assessment of PAP using AT:RVET(c) may permit the early prediction of CLD as part of a multifactorial scoring system.
Authors: Philip T Levy; Meghna D Patel; Georgeann Groh; Swati Choudhry; Joshua Murphy; Mark R Holland; Aaron Hamvas; Mark R Grady; Gautam K Singh Journal: J Am Soc Echocardiogr Date: 2016-09-15 Impact factor: 5.251
Authors: Meghna D Patel; Colm R Breatnach; Adam T James; Swati Choudhry; Patrick J McNamara; Amish Jain; Orla Franklin; Aaron Hamvas; Luc Mertens; Gautam K Singh; Afif El-Khuffash; Philip T Levy Journal: J Am Soc Echocardiogr Date: 2019-07 Impact factor: 5.251
Authors: Matthew M Laughon; John C Langer; Carl L Bose; P Brian Smith; Namasivayam Ambalavanan; Kathleen A Kennedy; Barbara J Stoll; Susie Buchter; Abbot R Laptook; Richard A Ehrenkranz; C Michael Cotten; Deanne E Wilson-Costello; Seetha Shankaran; Krisa P Van Meurs; Alexis S Davis; Marie G Gantz; Neil N Finer; Bradley A Yoder; Roger G Faix; Waldemar A Carlo; Kurt R Schibler; Nancy S Newman; Wade Rich; Abhik Das; Rosemary D Higgins; Michele C Walsh Journal: Am J Respir Crit Care Med Date: 2011-03-04 Impact factor: 21.405
Authors: Daniel E Ehrmann; Peter M Mourani; Steven H Abman; Brenda B Poindexter; Lindsey A Morrow; Brandie D Wagner; Michael V Di Maria Journal: J Pediatr Date: 2018-09-21 Impact factor: 4.406