Utility of echocardiography in predicting mortality in infants with severe bronchopulmonary dysplasia.

Creator(s)

Shilpa Vyas-Read
Erica M. Wymore
Isabella Zaniletti
Karna Murthy
Michael A. Padula
William E. Truog, Children's Mercy HospitalFollow
William A. Engle
Rashmin C. Savani
Sushmita Yallapragada
J Wells Logan
Huayan Zhang
Erik B. Hysinger
Theresa R. Grover
Girija Natarajan
Leif D. Nelin
Nicolas F M Porta
Karin P. Potoka
Robert DiGeronimo
Joanne M. Lagatta
Children’s Hospitals Neonatal Consortium Severe BPD Focus Group

Document Type

Article

Publication Date

1-2020

Identifier

DOI: 10.1038/s41372-019-0508-5; PMCID: PMC7222140

Abstract

OBJECTIVE: To determine the relationship between interventricular septal position (SP) and right ventricular systolic pressure (RVSP) and mortality in infants with severe BPD (sBPD).

STUDY DESIGN: Infants with sBPD in the Children's Hospitals Neonatal Database who had echocardiograms 34-44 weeks' postmenstrual age (PMA) were included. SP and RVSP were categorized normal, abnormal (flattened/bowed SP or RVSP > 40 mmHg) or missing.

RESULTS: Of 1157 infants, 115 infants (10%) died. Abnormal SP or RVSP increased mortality (SP 19% vs. 8% normal/missing, RVSP 20% vs. 9% normal/missing, both p < 0.01) in unadjusted and multivariable models, adjusted for significant covariates (SP OR 1.9, 95% CI 1.2-3.0; RVSP OR 2.2, 95% CI 1.1-4.7). Abnormal parameters had high specificity (SP 82%; RVSP 94%), and negative predictive value (SP 94%, NPV 91%) for mortality.

CONCLUSIONS: Abnormal SP or RVSP is independently associated with mortality in sBPD infants. Negative predictive values distinguish infants most likely to survive.

Journal Title

Journal of perinatology : official journal of the California Perinatal Association

Volume

40

Issue

1

First Page

149

Last Page

156

MeSH Keywords

Blood Pressure; Bronchopulmonary Dysplasia; Echocardiography; Female; Heart Septal Defects, Ventricular; Hospital Mortality; Humans; Infant, Newborn; Infant, Premature; Intensive Care Units, Neonatal; Male; Prognosis; Ventricular Septum

Keywords

Blood Pressure; Bronchopulmonary Dysplasia; Echocardiography; Female; Heart Septal Defects, Ventricular; Hospital Mortality; Humans; Infant, Newborn; Infant, Premature; Intensive Care Units, Neonatal; Male; Prognosis; Ventricular Septum

Recommended Citation

Vyas-Read S, Wymore EM, Zaniletti I, et al. Utility of echocardiography in predicting mortality in infants with severe bronchopulmonary dysplasia. J Perinatol. 2020;40(1):149-156. doi:10.1038/s41372-019-0508-5