Samuel J. Gentle, Avinash Singh, Colm P. Travers, Arie Nakhmani, Waldemar A. Carlo, Namasivayam Ambalavanan
University of Alabama at Birmingham.
United States
Archives of Disease in Childhood
Arch Dis Child 2024;
DOI: 10.1136/archdischild-2024-327014
Abstract
Objective: Characterisation of oxygen saturation (SpO2)-related predictors that correspond with both bronchopulmonary dysplasia-associated pulmonary hypertension (BPD-PH) development and survival status in infants with BPD-PH may improve patient outcomes. This investigation assessed whether (1) infants with BPD-PH compared with infants with BPD alone, and (2) BPD-PH non-survivors compared with BPD-PH survivors would (a) achieve lower SpO2 distributions, (b) have a higher fraction of inspired oxygen (FiO2) exposure and (c) have a higher oxygen saturation index (OSI).
Design: Case-control study between infants with BPD-PH (cases) and BPD alone (controls) and by survival status within cases.
Setting: Single-centre study in the USA.
Patients: Infants born at <29 weeks’ gestation and on respiratory support at 36 weeks’ postmenstrual age.
Exposures: FiO2 exposure, SpO2 distributions and OSI were analysed over the week preceding BPD-PH diagnosis.
Main outcomes and measures: BPD-PH, BPD alone and survival status in infants with BPD-PH.
Results: 40 infants with BPD-PH were compared with 40 infants with BPD alone. Infants who developed BPD-PH achieved lower SpO2 compared with infants with BPD (p<0.001), were exposed to a higher FiO2 (0.50 vs 0.34; p=0.02) and had a higher OSI (4.3 vs 2.6; p=0.03). Compared with survivors, infants with BPD-PH who died achieved a lower SpO2 (p<0.001) and were exposed to a higher FiO2 (0.70 vs 0.42; p=0.049).
Conclusions: SpO2-related predictors differed between infants with BPD-PH and BPD alone and among infants with BPD-PH by survival status. The OSI may provide a non-invasive predictor for BPD-PH in preterm infants.
Category
Class III. Pulmonary Hypertension Associated with Lung Disease
Class III. Pulmonary Hypertension Associated with Alveolar Hypoxia
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: Yes