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The association between pulmonary vascular disease and respiratory improvement in infants with type I severe bronchopulmonary dysplasia

Journal of Perinatology volume 42, pages 788–795 (2022)Cite this article

Subjects

Abstract

Objective

To describe the association between echocardiographic measures of pulmonary vascular disease and time to respiratory improvement among infants with Type I severe bronchopulmonary dysplasia (sBPD).

Study design

We measured the pulmonary artery acceleration time indexed to the right ventricular ejection time (PAAT/RVET) and right ventricular free wall longitudinal strain (RVFWLS) at 34-41 weeks’ postmenstrual age. Cox-proportional hazards models were used to estimate the relationship between the PAAT/RVET, RVFWLS, and the outcome: days from 36 weeks’ postmenstrual age to room-air or discharge with oxygen (≤0.5 L/min).

Result

For 102 infants, the mean PAAT/RVET and RVFWLS were 0.27 ± 0.06 and −22.63 ± 4.23%. An abnormal measurement was associated with an increased time to achieve the outcome (PAAT/RVET: 51v24, p < 0.0001; RVFWLS; 62v38, p = 0.0006). A normal PAAT/RVET was independently associated with a shorter time to outcome (aHR = 2.04, 1.11–3.76, p = 0.02).

Conclusion

The PAAT/RVET may aid in anticipating timing of discharge in patients with type I severe BPD.

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Fig. 1: PAAT/RVET measurement.
Fig. 2: Respiratory Support Liberation in Type 1 Severe BPD.
Fig. 3: Respiratory Support Liberation in Type 1 Severe BPD.

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Acknowledgements

Thank you to the Lurie Children’s Hospital of Chicago Division of Cardiology and Echocardiography Laboratory for training in image and measurement acquisition.

Funding

Supported in part by the Stanley Manne Children’s Research Institute and the Ann & Robert H. Lurie Children’s Hospital of Chicago. Research Electronic Data Capture is supported at the Feinberg School of Medicine by the Northwestern University Clinical and Translational Science Institute. Research reported in this publication was supported, in part, by the National Institutes of Health’s National Center for Advancing Translational Sciences, Grant Number UL1TR001422. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Ann & Robert H. Lurie Children’s Hospital of Chicago and the Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Ryan J. Carpenter, Karen Rychlik, Shawn K. Sen, Nicolas F. M. Porta, Aaron E. Hamvas, Karna Murthy & Amanda L. Hauck

  2. Biostatistics Collaboration Center, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Nina Srdanovic

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Contributions

RJC contributed to study design, methodology, investigation, funding, data curation, formal analysis, drafted the initial manuscript, and edited the manuscript. As corresponding author RJC confirms full access to the data and final responsibility for the decision to submit. NS and KR contributed to formal analysis and edited the manuscript. SKS and NFMP contributed to study design, methodology, investigation, provided supervision, and edited the manuscript. AEH contributed to study design, provided supervision, and edited the manuscript. KM contributed to study design, methodology, investigation, funding, formal analysis, provided supervision, and edited the manuscript. ALH contributed to study design, methodology, investigation, funding, data curation, formal analysis, provided supervision, and edited the manuscript.

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Correspondence to Ryan J. Carpenter.

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Competing interests

KM is the chairperson and active board member of the Children’s Hospital Neonatal Consortium (CHNC). CHNC’s database was used to identify patients eligible for inclusion. There was no, other involvement from CHNC, including study design, collection, analysis, interpretation of data, the writing of the report, and the decision to submit for publication. There are no other conflicts of interest to disclose.

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Carpenter, R.J., Srdanovic, N., Rychlik, K. et al. The association between pulmonary vascular disease and respiratory improvement in infants with type I severe bronchopulmonary dysplasia. J Perinatol 42, 788–795 (2022). https://doi.org/10.1038/s41372-022-01386-6

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