Document Detail

Frontiers in pulmonary hypertension in infants and children with bronchopulmonary dysplasia.
MedLine Citation:
PMID:  22777709     Owner:  NLM     Status:  MEDLINE    
Pulmonary hypertension (PH) is an increasingly recognized complication of premature birth and bronchopulmonary dysplasia (BPD), and is associated with increased morbidity and mortality. Extreme phenotypic variability exists among preterm infants of similar gestational ages, making it difficult to predict which infants are at increased risk for developing PH. Intrauterine growth retardation or drug exposures, postnatal therapy with prolonged positive pressure ventilation, cardiovascular shunts, poor postnatal lung and somatic growth, and genetic or epigenetic factors may all contribute to the development of PH in preterm infants with BPD. In addition to the variability of severity of PH, there is also qualitative variability seen in PH, such as the variable responses to vasoactive medications. To reduce the morbidity and mortality associated with PH, a multi-pronged approach is needed. First, improved screening for and increased recognition of PH may allow for earlier treatment and better clinical outcomes. Second, identification of both prenatal and postnatal risk factors for the development of PH may allow targeting of therapy and resources for those at highest risk. Third, understanding the pathophysiology of the preterm pulmonary vascular bed may help improve outcomes through recognizing pathways that are dysregulated in PH, identifying novel biomarkers, and testing novel treatments. Finally, the recognition of conditions and exposures that may exacerbate or lead to recurrent PH is needed to help with developing treatment guidelines and preventative strategies that can be used to reduce the burden of disease.
Joseph M Collaco; Lewis H Romer; Bridget D Stuart; John D Coulson; Allen D Everett; Edward E Lawson; Joel I Brenner; Anna T Brown; Melanie K Nies; Priya Sekar; Lawrence M Nogee; Sharon A McGrath-Morrow
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Publication Detail:
Type:  Journal Article; Review     Date:  2012-07-06
Journal Detail:
Title:  Pediatric pulmonology     Volume:  47     ISSN:  1099-0496     ISO Abbreviation:  Pediatr. Pulmonol.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-10-19     Completed Date:  2013-04-15     Revised Date:  2014-03-28    
Medline Journal Info:
Nlm Unique ID:  8510590     Medline TA:  Pediatr Pulmonol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1042-53     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Wiley Periodicals, Inc.
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MeSH Terms
Anesthesia / adverse effects
Biological Markers / analysis
Bronchopulmonary Dysplasia / complications*,  diagnosis,  epidemiology,  metabolism,  physiopathology
Cardiac Catheterization / methods
Child, Preschool
Echocardiography / methods
Hypertension, Pulmonary / diagnosis,  epidemiology,  etiology*,  metabolism,  physiopathology
Infant, Newborn
Risk Factors
Severity of Illness Index
Grant Support
Reg. No./Substance:
0/Biological Markers

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