Pulmonary Hypertension Associated with Bronchopulmonary Dysplasia: A Review

Pediatr Allergy Immunol Pulmonol. 2019 Dec 1;32(4):140-148. doi: 10.1089/ped.2018.0984. Epub 2019 Dec 11.

Abstract

Early pulmonary vascular disease (PVD) and established pulmonary hypertension (PH) are common associations of bronchopulmonary dysplasia (BPD). Diagnosis of PH is often made by echocardiography because of technical and logistic difficulties with the neonatal population. Optimization of respiratory support is the focus of treatment, however, medical therapies are being used with increased frequency. The prognosis for PH associated with BPD (PH-BPD) is tied to the child's respiratory status. PH is associated with increased risk of death in this population, so active screening and treatment is recommended to minimize morbidity and mortality. In this review, we discuss the pathophysiology of PH in infants with BPD, evaluate the current understanding of screening, diagnosis, and follow-up evaluation; describe comorbid conditions; and provide a framework for targeted physiology-based management strategies.

Keywords: bronchopulmonary dysplasia; mechanical ventilation; newborns; prematurity; pulmonary hypertension; pulmonary vascular disease; pulmonary vein stenosis; sildenafil.

Publication types

  • Review