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Oxygen requirement as a screening tool for the detection of late pulmonary hypertension in extremely low birth weight infants

Published online by Cambridge University Press:  29 June 2015

Rohit Aswani ,
Lisa Hayman ,
Gina Nichols ,
Angel A. Luciano ,
Ernest K. Amankwah ,
Jennifer L. Leshko  and
Gul H. Dadlani
Rohit Aswani
Affiliation:
Department of Pediatrics, University of South Florida Morsani College of Medicine, Tampa, Florida, United States of America
Lisa Hayman
Affiliation:
Department of Pediatrics, University of South Florida Morsani College of Medicine, Tampa, Florida, United States of America
Gina Nichols
Affiliation:
Department of Pediatrics, University of South Florida Morsani College of Medicine, Tampa, Florida, United States of America
Angel A. Luciano
Affiliation:
Department of Pediatrics, University of South Florida Morsani College of Medicine, Tampa, Florida, United States of America
Ernest K. Amankwah
Affiliation:
Clinical and Translational Research Organization, Johns Hopkins All Children’s Hospital, St Petersburg, Florida, United States of America
Jennifer L. Leshko
Affiliation:
Clinical and Translational Research Organization, Johns Hopkins All Children’s Hospital, St Petersburg, Florida, United States of America
Gul H. Dadlani*
Affiliation:
Department of Pediatrics, University of South Florida Morsani College of Medicine, Tampa, Florida, United States of America Johns Hopkins All Children’s Heart Institute, All Children’s Hospital, Saint Petersburg, Florida, United States of America
*
Correspondence to: G. H. Dadlani, MD, Johns Hopkins All Children’s Heart Institute, 601 5th Street South #206, St. Petersburg, FL 33701, United States of America. Tel: +727 767 3333; Fax: +727 767 8990; E-mail: [email protected]
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Abstract

Background

Many extremely low birth weight infants develop pulmonary hypertension late in their clinical course, and over 60% go undetected by early screening echocardiography. At present, no standardised screening protocol exists for detecting late pulmonary hypertension in extremely low birth weight infants. We assessed the utility of oxygen supplementation as a predictor of late pulmonary hypertension.

Methods

A retrospective single-centre review of extremely low birth weight infants with no evidence of CHD and those surviving for >30 days was performed. The association between oxygen ⩾30% at day of life 30 and diagnosis of late pulmonary hypertension was estimated with an odds ratio and 95% confidence interval using logistic regression. Doppler echocardiography was used to diagnose pulmonary hypertension in the infants.

Results

A total of 230 infants met the study criteria. The incidence of late pulmonary hypertension was 8.3% (19/230). Infants with late pulmonary hypertension were more likely to have a lower mean birth weight (667.1±144 versus 799.3±140 g, p=0.001) and more likely to be small for gestational age (47.4 versus 14.2%, p=0.004). Oxygen requirement ⩾30% at day of life 30 was associated with increased risk of late pulmonary hypertension (odds ratio=3.77, 95% confidence interval=1.42–10.00, p=0.008) in univariate analysis and after adjusting for birth weight (odds ratio=2.47, 95% confidence interval=0.89–6.84, p=0.08).

Conclusions

The need of oxygen supplementation ⩾30% at day of life 30 may be a good screening tool for detecting late pulmonary hypertension in extremely low birth weight infants.

Keywords

Pulmonary hypertensionextremely low birth weight infantsscreening testoxygen requirementbronchopulmonary dysplasiaechocardiography
Type
Original Articles
Information
Cardiology in the Young , Volume 26 , Issue 3 , March 2016 , pp. 521 - 527
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Copyright
© Cambridge University Press 2015 

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