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Correlation of the ventilatory needs of infants with CLD of prematurity with the existence of pulmonary hypertension- A single centre10 year observational study
  • Doctor T H,
  • Panagiota Panagiotou,
  • Simona Turcu
Doctor T H
University Hospitals of Leicester NHS Trust

Corresponding Author:taheradoctor@yahoo.com

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Panagiota Panagiotou
Evelina London Children's Hospital
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Simona Turcu
Evelina London Children's Hospital
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Abstract

Objective: During the past two decades an increased survival of ex preterm infants has been observed 18. This is due to the improvement in neonatal care and due to the contribution of the ongoing evolving field of long term ventilation, invasive and non invasive 18. As per National Confidential Enquiry into Patient Outcome and Death (NCEPOD) report the number of children and young people reported to be receiving LTV in the UK increased from 1 in 1975 to almost 1,400 in 2013 6.9% patients on LTV were due to chronic respiratory diseases and within that group,34.4% related to prematurity . 6Preterm infants with Chronic Lung Disease (CLD)or bronchopulmonary dysplasia (BPD)require ventilatory support for long periods and thus they may be discharged home on long term ventilation. Their clinical status may be also complicated by pulmonary hypertension. Aim: In this observational study we aim to describe the course of resolution of pulmonary hypertension in ex premature infants on long term ventilation –invasive or non-invasive, due to severe bronchopulmonary dysplasia (BPD) and assess if there is any difference in the timeframe of weaning off the ventilation between the group of ex premature infants with and without pulmonary hypertension. Design, Setting and Patients: We conducted a retrospective analysis of the long-term ventilation (LTV) database held within the Evelina London Children´s Hospital paediatric respiratory department. The interval analysis was between August 2011 to August 2021. We screened 360 children on LTV in order to identify preterm (<37-week gestational age) infants. We have described this cohort for their demographic characteristics, comorbidities, ventilatory interface, ventilation needs and weaning course and the presence or not of pulmonary hypertension Results: The majority of the patients needed bilevel ventilation (BiPAP). (BiPAP/CPAP ratio: 37/11). 22 out of 48 patients on LTV were liberated from their ventilators at the time of the study, the cohort on NIV had better outcomes than the tracheostomy cohort but this is mostly related to less severe BPD. Pulmonary hypertension has resolved for all patients apart from 3. Conclusion: Ex premature infants with BPD and pulmonary hypertension have good chances to be weaned off ventilation and that their pulmonary hypertension will resolve NIV patient progress better than those ventilated via tracheostomy. More research is needed in this field in order to investigate further the correlation of pulmonary hypertension and ventilatory needs and vice versa in this group of patients.