Related Experiment Video
Updated: Feb 18, 2026
Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
Published on: January 27, 2023
Results of a pulmonary hypertension screening program for premature infants with bronchopulmonary dysplasia
Ramya Ramachandra1, Alisa Arunamata1, Amanda Moy2
1Division of Pediatric Cardiology, Department of Pediatrics, Stanford University School of Medicine, Lucile Packard Children's Hospital Stanford, Palo Alto, CA, USA.
Insights
Pulmonary hypertension (PH) screening in premature infants with bronchopulmonary dysplasia (BPD) using echocardiography detected PH in 15%. Serum NT-proBNP was not a reliable screening tool.
Area of Science:
- Neonatology
- Pediatric Cardiology
- Respiratory Medicine
Background:
- Premature infants with bronchopulmonary dysplasia (BPD) face increased risk of pulmonary hypertension (PH).
- Early detection of PH is crucial for managing BPD complications.
- Existing screening methods require evaluation for effectiveness.
Purpose of the Study:
- To evaluate the outcomes of a pulmonary hypertension (PH) screening protocol in premature infants with bronchopulmonary dysplasia (BPD).
- To assess the utility of echocardiography and serum NT-proBNP levels in PH screening.
Main Methods:
- Retrospective cohort study of premature infants with moderate to severe BPD.
- Screening included echocardiogram and serum NT-proBNP at 36 weeks postmenstrual age.
- Data collected from June 2017 to November 2022.
Main Results:
- Echocardiography detected PH in 15% of infants (95% CI 10.0%, 22.1%).
- Lower gestational age was associated with increased PH incidence.
- Serum NT-proBNP showed low sensitivity (57%) and specificity (45%).
- No significant difference in right ventricular systolic function was observed between infants with and without PH.
Conclusions:
- Echocardiographic screening effectively identifies PH in infants with BPD before significant right ventricular dysfunction occurs.
- Serum NT-proBNP is not a reliable biomarker for PH screening in this population.
- Routine echocardiographic screening is recommended for infants with BPD.
Objective:
Premature infants with bronchopulmonary dysplasia (BPD) are at risk for pulmonary hypertension (PH). We sought to evaluate outcomes of a PH screening protocol.
Study Design:
Single-center retrospective cohort study of premature infants with ≥moderate BPD from 6/2017 to 11/2022 subject to an institutional PH screening protocol that included echocardiogram and serum N-terminal pro B-type natriuretic peptide (NT-proBNP) levels measured at 36 weeks postmenstrual age.
Result:
Screening echocardiography detected PH in 15% (95% CI 10.0%, 22.1%). Multivariate analysis identified an association between lower gestational age and incidence of PH. There was no difference in right ventricular systolic function metrics among infants with PH compared to those without. Sensitivity and specificity of serum NT-proBNP were 57% and 45%, respectively.
Conclusion:
Echocardiographic screening can detect unrecognized PH in infants before significant decrement of right ventricular performance, while serum NT-proBNP may not be a reliable screening tool for PH in infants with BPD.
Related Concept Videos
01:25Pulmonary Function Tests
Pulmonary Function Tests are crucial diagnostic tools for assessing respiratory function, particularly in patients with chronic respiratory disorders. They comprehensively evaluate lung volumes, ventilatory function, breathing mechanics, diffusion, and gas exchange. These tests help diagnose pulmonary diseases and play a significant role in monitoring disease progression, evaluating disability, and assessing response to therapy.
PFTs involve using a spirometer, a...
01:30Pulmonary Hypertension: Classification and Pathogenesis
There are various classifications for PH, each relating to different underlying causes and also...
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care