Shilpa Vyas-Read, Shazia Bhombal, Roopa Siddaiah, Clifford L. Cua, Amulya Buddhavarapu, Robin L. McKinney, Philip T. Levy, Amanda L. Hauck, Nicolas F. M. Porta, Kathleen A. Gibbs, Krithika Lingappan, Matthew S. Douglass, Eric D. Austin, Steven H. Abman, Ronald W. Day
Emory University and Children’s Healthcare of Atlanta. Arkansas Children’s Hospital. Ohio State University and Nationwide Children’s Hospital. Warren Alpert Medical School of Brown University and Hasbro Children’s Hospital. Harvard Medical School and Boston Children’s Hospital. Northwestern University Feinberg School of Medicine and Lurie Children’s Hospital. University of Pennsylvania Perelman School of Medicine and Children’s Hospital of Philadelphia, University of Utah. Vanderbilt University Medical Center. University of Colorado and Children’s Hospital Colorado Anschutz Medical Campus.
United States
Children
Children 2026; 13:
DOI: 10.3390/children13050646
Abstract
Background: Echocardiography is a non-invasive test that is readily used to detect pulmonary hypertension associated with bronchopulmonary dysplasia (BPD-PH) and right ventricular failure (RVF). However, the most feasible, reproducible and accurate parameters to measure and use for guidance in addressing patient care have not been established and may differ between subspecialties.
Methods: We surveyed members of the BPD Collaborative to determine how different care providers clinically evaluate infants for BPD-PH and RVF. Perceived challenges and obstacles that limit the utility of echocardiography are also reported.
Results: Of the 108 survey respondents from ~45 centers, 55.6% were neonatologists, 18.5% were pediatric pulmonologists or pediatric intensive care physicians, 15.7% were pediatric cardiologists or pulmonary hypertension specialists, and 10.2% were other providers. Responses revealed discrepancies between specialists concerning the use of standard echocardiographic protocols and parameters that can be measured serially with relative ease, metrics that should be used to best define and distinguish the severity of BPD-PH or RVF, and parameter values that should be used to determine whether changes in PH-targeted medical therapies, hemodynamic or respiratory support are needed. Free text responses identified patient-, protocol-, cardiology-, technician-, and BPD-PH definition-related obstacles that may limit the reliable utility of echocardiography.
Conclusions: Although most providers agree that echocardiography is feasible and of value, variability exists between subspecialists and centers, suggesting the need for improved standardization of imaging protocols and BPD-PH definition, consistent test interpretation, and effective communication of results to improve the reproducibility and accuracy of echocardiography in infants with BPD.
Category
Class III. Pulmonary Hypertension Associated with Lung Disease
Heart Dysfunction Associated with Pulmonary Vascular Disease (Right)
Diagnostic Testing for Pulmonary Vascular Disease. Non-invasive Testing
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