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Advances in paediatric pulmonary vascular disease associated with bronchopulmonary dysplasia

Thomas Rossor1, Anne Greenough

  • 1Division of Asthma, Allergy and Lung Biology, MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, London, England, UK.

Expert Review of Respiratory Medicine
|November 27, 2014
PubMed

Insights

Recent advances in diagnosing and treating pulmonary hypertension (PH) in infants with bronchopulmonary dysplasia (BPD) show promise, but more research is needed to confirm long-term benefits.

Area of Science:

  • Pediatrics
  • Neonatology
  • Cardiology

Background:

  • Pulmonary hypertension (PH) is a frequent complication in infants with bronchopulmonary dysplasia (BPD).
  • Effective management strategies for BPD-related PH are crucial for improving patient outcomes.

Purpose of the Study:

  • To review recent advancements in the diagnosis and treatment of PH.
  • To evaluate the potential benefits of these advances for infants and children with BPD-related PH.

Main Methods:

  • Literature review of recent studies on PH diagnosis and treatment in BPD.
  • Analysis of current diagnostic tools, including echocardiography, and emerging biomarkers.
  • Assessment of various therapeutic options, such as inhaled nitric oxide, sildenafil, prostacyclin, PDE3 inhibitors, and endothelin receptor blockers.

Main Results:

  • Echocardiography is the primary diagnostic tool but has limitations; improved diagnostic techniques and biomarkers are needed.
  • Inhaled nitric oxide offers short-term benefits only.
  • Sildenafil demonstrated significant mortality reduction in resource-limited settings.
  • Evidence for other therapies (prostacyclin, PDE3 inhibitors, endothelin receptor blockers) is limited to case reports/series.

Conclusions:

  • Further randomized controlled trials with long-term follow-up are essential to establish the efficacy of PH therapies in children with BPD.
  • Developing novel diagnostic methods and biomarkers is critical for accurate PH assessment in this population.

Keywords:
bronchopulmonary dysplasiapulmonary hypertensionpulmonary vascular disease

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