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Published on: May 11, 2015
Targeted Therapy for Pulmonary Hypertension in Premature Infants
Shannon N Nees1, Erika B Rosenzweig1, Jennifer L Cohen2
1Division of Pediatric Cardiology, Columbia University Irving Medical Center, New York, NY 10032, USA.
Pharmacologic management for premature infants with bronchopulmonary dysplasia-associated pulmonary hypertension (BPD-PH) shows high mortality, but survivors can often discontinue therapies within years. This study details treatment outcomes for BPD-PH.
Area of Science:
- Neonatology
- Pediatric Cardiology
- Pulmonology
Background:
- Pulmonary hypertension (PH) is a serious complication in premature infants with bronchopulmonary dysplasia (BPD).
- Limited data exists on the safety and effectiveness of targeted PH therapies in infants with BPD-PH.
Purpose of the Study:
- To describe the pharmacologic management of BPD-PH.
- To report on the safety and outcomes of BPD-PH treatment at a single institution.
Main Methods:
- Retrospective review of premature infants diagnosed with BPD-PH between 2005 and 2016.
- Analysis of pharmacologic treatments used, including sildenafil, bosentan, inhaled iloprost, intravenous epoprostenol, and subcutaneous treprostinil.
- Follow-up data collected through January 2020 to assess outcomes.
Main Results:
- 101 infants with BPD-PH were included; 98% received sildenafil.
- Overall mortality was 32.7%, with 9.9% attributed to severe PH.
- Of survivors, 83.8% had follow-up, and 77.2% were weaned off PH medications within a median of 2 years.
Conclusions:
- Mortality in BPD-PH remains high, often due to comorbidities.
- For infants surviving BPD-PH, targeted therapies can frequently be discontinued within the first few years of life.
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