Häfner, Friederike and Johansson, Caroline and Schwarzkopf, Larissa and Förster, Kai and Kraus, Yvonne and Flemmer, Andreas W. and Hansmann, Georg and Sallmon, Hannes and Felderhoff‐Müser, Ursula and Witt, Sabine and Schwettmann, Lars and Hilgendorff, Anne (2023) Current diagnosis and treatment practice for pulmonary hypertension in bronchopulmonary dysplasia: a survey study in Germany (PUsH BPD). Pulmonary circulation, 13 (4). pp. 1-14. ISSN 2045-8940

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Abstract

Pulmonary hypertension (PH) is the most severe complication in preterm infants with bronchopulmonary dysplasia (BPD) and associated with significant mortality. Diagnostic and treatment strategies, however, still lack standardization. By the use of a survey study (PH in BPD), we assessed clinical practice (diagnosis, treatment, follow-up) in preterm infants with early postnatal persistent pulmonary hypertension of the newborn (PPHN) as well as at risk for or with established BPD-associated PH between 06/2018 and 10/2020 in two-thirds of all German perinatal centers with >70 very low birthweight infants/year including their cardiology departments and outpatient units. Data were analyzed descriptively by measures of locations and distributional shares. In routine postnatal care, clinical presentation and echocardiography were reported as the main diagnostic modalities to screen for PPHN in preterm infants, whereas biomarkers brain natriuretic peptide/N-terminal pro b-type natriuretic peptide were infrequently used. For PPHN treatment, inhaled nitric oxide was used in varying frequency. The majority of participants agreed to prescribe diuretics and steroids (systemic/inhaled) for infants at risk for or with established BPD-associated PH and strongly agreed on recommending respiratory syncytial virus immunization and the use of home monitoring upon discharge. Reported oxygen saturation targets, however, varied in these patients in in- and outpatient care. The survey reveals shared practices in diagnostic and therapeutic strategies for preterms with PPHN and BPD-associated PH in Germany. Future studies are needed to agree on detailed echo parameters and biomarkers to diagnose and monitor disease next to a much-needed agreement on the use of pulmonary vasodilators, steroids, and diuretics as well as target oxygen saturation levels.

Item Type:	Article
Uncontrolled Keywords:	bronchopulmonary dysplasia, chronic lung disease, clinical practice, preterm infant,pulmonary hypertension
Subjects:	Technology, medicine, applied sciences > Medicine and health
Divisions:	Faculty of Medicine and Health Sciences > Department of Public Health and Medical Education
Date Deposited:	09 Jan 2024 12:05
Last Modified:	09 Jan 2024 12:05
URI:	https://oops.uni-oldenburg.de/id/eprint/5933
URN:	urn:nbn:de:gbv:715-oops-60149
DOI:	10.1002/pul2.12320
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