Related Experiment Video
Updated: Jun 22, 2025
Increasing Pulmonary Artery Pulsatile Flow Improves Hypoxic Pulmonary Hypertension in Piglets
Published on: May 11, 2015
Optimizing management of chronic pulmonary hypertension in preterm infants: strategies for a complex population
Carolina Michel-Macías1,2, Audrey Hébert3, Gabriel Altit2
1Universidad Autónoma de Querétaro, Facultad de Medicina, Querérato, Mexico.
Insights
Managing pulmonary hypertension in premature infants with bronchopulmonary dysplasia is crucial. Early intervention with ventilatory support, diuretics, and vasodilators, guided by echocardiography, improves outcomes and reduces mortality.
Area of Science:
- Neonatal Medicine
- Pediatric Cardiology
- Pulmonary Medicine
Background:
- Pulmonary hypertension (PH) is a significant complication in premature infants with bronchopulmonary dysplasia (BPD).
- BPD-PH is linked to adverse outcomes and increased mortality in this vulnerable population.
- The condition involves complex pulmonary vasculature changes with potential arterial and postcapillary components.
Purpose of the Study:
- To review the current management strategies for pulmonary hypertension in infants with bronchopulmonary dysplasia.
- To explore the heterogeneous effects and potential arterial and postcapillary involvement in BPD-PH.
- To highlight the role of diagnostic tools and therapeutic interventions in managing BPD-PH.
Main Methods:
- Review of current literature and observational studies on BPD-PH management.
- Focus on optimizing ventilatory support and treating underlying lung disease.
- Utilizing echocardiography for diagnosis, treatment guidance, and monitoring disease progression.
Main Results:
- Optimizing ventilatory support and treating the underlying lung disease are foundational.
- Diuretics are recommended for initial management, especially with right ventricular dilation.
- Pulmonary vasodilator therapy is often necessary to reduce right ventricular strain and prevent cardiac complications.
- Echocardiography is essential for guiding treatment decisions and monitoring BPD-PH.
Conclusions:
- BPD-PH significantly increases mortality risk and long-term cardio-respiratory morbidity.
- Echocardiography is valuable for screening, with catheterization for complex cases.
- Effective BPD-PH management necessitates a multidisciplinary approach focusing on BPD treatment and underlying pathologies.
Purpose Of Review:
Pulmonary hypertension (PH) is commonly observed in premature infants with bronchopulmonary dysplasia (BPD) and is associated with poor outcomes and increased mortality. This review explores the management of this intricate condition of the pulmonary vasculature, which exhibits heterogeneous effects and may involve both arterial and postcapillary components.
Recent Findings:
Current management of BPD-PH should focus on optimizing ventilatory support, which involves treatment of underlying lung disease, transitioning to a chronic phase ventilation strategy and evaluation of the airway. Data on management is limited to observational studies. Diuretics are considered a part of the initial management, particularly in infants with right ventricular dilation. In many cases, pulmonary vasodilator therapy is required to induce pulmonary arterial vasodilation, reduce right ventricular strain, and prevent coronary ischemia and heart failure. Echocardiography plays a pivotal role in guiding treatment decisions and monitoring disease progression.
Summary:
BPD-PH confers a heightened risk of mortality and long-term cardio-respiratory adverse outcomes. Echocardiography has been advocated for screening, while catheterization allows for confirmation in select more complex cases. Successful management of BPD-PH requires a multidisciplinary approach, focusing on optimizing BPD treatment and addressing underlying pathologies.
Related Concept Videos
01:29Chronic Obstructive Pulmonary Disease-V: Management
Smoking Cessation
01:30Chronic Obstructive Pulmonary Disease-V: Nursing Management
Assessment
01:16Treatment for Pulmonary Arterial Hypertension: Oxygen Therapy for Respiratory Failure
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue,...
01:30Pulmonary Hypertension: Classification and Pathogenesis
There are various classifications for PH, each relating to different underlying causes and also...
01:23Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....