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Published on: May 11, 2015
Bronchopulmonary dysplasia - associated pulmonary hypertension: An updated review
Ahmed El-Saie1, Nidhy P Varghese2, Melissa K Webb3
1Section of Neonatology, Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO, USA.
Insights
Bronchopulmonary dysplasia (BPD) with pulmonary hypertension (PH) is a severe complication of prematurity. This review summarizes recent advances in preventing and managing BPD-PH to improve infant outcomes.
Area of Science:
- Neonatology
- Pediatric Pulmonology
- Cardiology
Background:
- Bronchopulmonary dysplasia (BPD) is the primary chronic lung disease in premature infants, with increasing incidence due to improved neonatal survival.
- Pulmonary hypertension (PH) is a severe complication of BPD, affecting nearly one-third of infants with moderate to severe BPD.
- Current treatments for BPD-PH show suboptimal responses, highlighting the need for novel management strategies.
Approach:
- This review synthesizes current knowledge on the pathogenesis and pathophysiology of BPD-PH.
- It details diagnostic approaches for identifying BPD-PH in affected infants.
- The review summarizes existing and emerging treatment strategies for BPD-PH.
Key Points:
- Advances in neonatal care increase survival but maintain high BPD incidence.
- Pulmonary hypertension significantly elevates morbidity and mortality in BPD infants.
- Effective prevention and management of BPD-PH require updated understanding and novel interventions.
Conclusions:
- A comprehensive understanding of BPD-PH pathogenesis, diagnosis, and treatment is crucial.
- Developing new therapeutic strategies is essential to improve outcomes for infants with BPD-PH.
- Multidisciplinary collaboration is key to advancing the care of preterm infants with BPD-PH.
Abstract:
Bronchopulmonary dysplasia (BPD) is the leading cause of chronic lung disease in infants and the commonest complication of prematurity. Advances in respiratory and overall neonatal care have increased the survival of extremely low gestational age newborns, leading to the continued high incidence of BPD. Pulmonary hypertension (PH) represents the severe form of the pulmonary vascular disease associated with BPD, and affects almost one-third of infants with moderate to severe BPD. PH responds suboptimally to pulmonary vasodilators and increases morbidity and mortality in BPD infants. An up-to-date knowledge of the pathogenesis, pathophysiology, diagnosis, treatment, and outcomes of BPD-PH can be helpful to develop meaningful and novel strategies to improve the outcomes of infants with this disorder. Therefore, our multidisciplinary team has attempted to thoroughly review and summarize the latest advances in BPD-PH in preventing and managing this morbid lung disorder of preterm infants.
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