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Neonatal Med > Volume 18(1); 2011 > Article
Journal of the Korean Society of Neonatology 2011;18(1):96-103.
DOI: https://doi.org/10.5385/jksn.2011.18.1.96    Published online May 15, 2011.
Pulmonary Hypertension Secondary to Bronchopulmonary Dysplasia in Very Low Birth Weight Infants (<1,500 g).
Hye Soo Yoo, Myo Jing Kim, Ji Man Kang, Cha gon Lee, Jin Kyu Kim, So Yoon Ahn, Eun Sun Kim, June Huh, Yun Sil Chang, I Seok Kang, Won Soon Park, Heung Jae Lee
1Department of Pediatrics, Ilsan Paik Hospital, Inje University School of Medicine, Goyang, Korea.
2Department of Pediatrics, Dong-A Medical Center, Dong-A University School of Medicine, Busan, Korea.
3Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. ws123.park@samsung.com
Abstract
PURPOSE
Although infants with bronchopulmonary dysplasia (BPD) are at risk of developing secondary pulmonary hypertension (PH), which is associated with significant morbidity and mortality, little has been reported about the incidence, clinical course and prognosis of PH secondary to BPD in premature infants. This study was done to investigate the incidence, risk factors, clinical course, and the ultimate prognosis of PH developed secondary to BPD in very low birth weight infants (<1,500 g).
METHODS
Medical records of very low birth weight infant (VLBWI) admitted to Samsung Medical Center NICU from January 2000 to July 2007 were reviewed retrospectively. BPD was defined by Jobe's classification. The diagnosis of pulmonary hypertension was established as velocity of tricuspid valve regurgitation (TR) > or =3 m/s and a flattening of the intraventricular septum by conducting Doppler echocardiography.
RESULTS
The incidence of pulmonary hypertension was 6% in VLBWI with BPD and it developed in moderate to severe BPD. The diagnosis of pulmonary hypertension was made on postnatal 133 days (range 40-224 days) and the risk factors related to developing pulmonary hypertension were severe BPD, small for gestational age and outborn infants. The mortality rate was 57% and especially higher in severe BPD (70%). The time to recovery spent 3 months (range 1-10 months) in survived patients.
CONCLUSION
Based on the results of this research, pulmonary hypertension secondary to BPD in VLBWI related to severity of BPD and had a poor prognosis. We expect that regular long-term echocardiography may be helpful in treating reversible in VLBWI with moderate to severe BPD.
Key Words: Prematurity, Pulmonary hypertension, Bronchopulmonary dysplasia, Echocardiogram, Very low birth weight infant


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