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Systemic hypertension in infants with severe bronchopulmonary dysplasia: associated clinical factors
A H Anderson1, B A Warady, D K Daily
1Children's Mercy Hospital, University of Missouri-Kansas City School of Medicine.
Insights
Systemic hypertension (HTN) affects 13% of infants with bronchopulmonary dysplasia (BPD) on home oxygen. This condition is linked to severe lung disease, increased medication use, and higher mortality, but often resolves before oxygen weaning.
Area of Science:
- Pediatrics
- Neonatology
- Pulmonology
Background:
- Bronchopulmonary dysplasia (BPD) is a chronic lung disease in infants.
- Home oxygen therapy is common for infants with severe BPD.
- Systemic hypertension (HTN) is a potential complication in these infants.
Purpose of the Study:
- To determine the incidence of systemic hypertension (HTN) in infants with BPD on home oxygen.
- To identify clinical features associated with HTN in this population.
- To describe the clinical course and outcomes of HTN in infants with BPD.
Main Methods:
- Retrospective review of clinical data for 87 infants with BPD receiving home oxygen therapy.
- Comparison of clinical features between infants with and without systemic HTN.
- Analysis of medication use, duration of oxygen therapy, and mortality rates.
Main Results:
- 13% (11 of 87) of infants developed systemic HTN.
- Hypertensive infants showed increased use of bronchodilators and diuretics.
- Hypertensive infants required longer home oxygen therapy and had higher mortality (36% vs 1%).
Conclusions:
- Systemic hypertension is a frequent complication in infants with severe BPD.
- HTN is associated with greater disease severity and poorer outcomes.
- In surviving patients, HTN was benign and resolved prior to home oxygen discontinuation.
Abstract:
The clinical course of 87 infants with bronchopulmonary dysplasia (BPD) on home oxygen therapy was reviewed to determine the occurrence of systemic hypertension (HTN) and to evaluate associated clinical features. Eleven of 87 (13%) infants developed systemic HTN either in the neonatal intensive care unit or following discharge. Clinical features that distinguished the hypertensive from the normotensive group were as follows: greater use of bronchodilators, 91% vs 37% (p < 0.001), and diuretics, 91% vs 55% (p < 0.05), longer duration of home oxygen therapy 21.6 +/- 9.9 vs 9.2 +/- 5.8 months (p < 0.05), and greater mortality, 36% vs 1% (p < 0.001). The course of systemic HTN in the surviving patients (7 of 11) was benign and resolved in all patients prior to weaning from home oxygen therapy. Systemic HTN is frequently present in infants with severe BPD and appears to be related to the clinical severity of lung disease.