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Pulmonary Function Tests in Very Low Birth Weight Infants Screened for Pulmonary Hypertension: A Pilot Study - 22/09/21

Doi : 10.1016/j.jpeds.2021.06.046 
John D. Adair, MD 1, Brendan Kelly, MD 2, Diane Schilling, RRT 1, Kseniya Parkhotyuk, RRT 1, Ladawna Gievers, MD 1, Amanda Kim, MD 1, Brian Scottoline, MD, PhD 1, Cindy T. McEvoy, MD, MCR 1
1 Division of Neonatology, Department of Pediatrics, Oregon Health & Science University, Portland, OR 
2 Division of Pediatric Cardiology, Department of Pediatrics, Oregon Health & Science University, Portland, OR 

Abstract

Objective

To compare pulmonary function tests (PFTs), specifically respiratory system resistance (Rrs) and compliance (Crs), in very low birth weight (VLBW) infants with and without pulmonary hypertension.

Study design

Infants were included who underwent PFTs at 34-38 weeks postmenstrual age (PMA) as part of our pulmonary hypertension screening guidelines for infants born at ≤1500 g requiring respiratory support at ≥34 weeks PMA. One pediatric cardiologist reviewed and estimated right ventricular or pulmonary arterial pressure and defined pulmonary hypertension as an estimated pulmonary arterial pressure or right ventricular pressure greater than one-half the systemic pressure. Rrs and Crs were measured with the single breath occlusion technique and functional residual capacity with the nitrogen washout method according to standardized criteria.

Results

Twelve VLBW infants with pulmonary hypertension and 39 without pulmonary hypertension were studied. Those with pulmonary hypertension had significantly lower birth weight and a trend toward a lower gestational age. There were no other demographic differences between the groups. The infants with pulmonary hypertension had significantly higher Rrs (119 vs 78 cmH2O/L/s; adjusted P = .012) and significantly lower Crs/kg (0.71 vs 0.92 mL/cmH2O/kg; P = .04).

Conclusions

In this pilot study of VLBW infants screened for pulmonary hypertension at 34-38 weeks PMA, those with pulmonary hypertension had significantly increased Rrs and decreased Crs compared with those without pulmonary hypertension. Additional studies are needed to further phenotype infants with evolving BPD and pulmonary hypertension.

Il testo completo di questo articolo è disponibile in PDF.

Keywords : newborn pulmonary function, respiratory resistance, respiratory compliance, very low birth weight infants, pulmonary hypertension, bronchopulmonary dysplasia

Abbreviations : BPD, CPAP, Crs, Echo, FRC, NICU, NT-proBNP, OHSU, PFT, PMA, Rrs, VLBW


Mappa


 Supported by NIH, NHLBI HL105447 and HL129060 and NIH UH3OD023288 (to C.M.) and by a Pratt Family Foundation grant (to J.A.). The study sponsors had no role in the study design; collection, analysis, and interpretation of data; manuscript preparation; or the decision to submit the manuscript for publication. The authors declare no conflicts of interest.


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Vol 237

P. 221 - ottobre 2021 Ritorno al numero
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