Outcomes of infants and children with bronchopulmonary dysplasia-associated pulmonary hypertension who required home ventilation.
Document Type
Article
Publication Date
1-2025
Identifier
DOI: 10.1038/s41390-024-03495-8
Abstract
BACKGROUND: To characterize a cohort of ventilator-dependent infants and children with bronchopulmonary dysplasia-associated pulmonary hypertension (BPD-PH) and to describe their cardiorespiratory outcomes.
METHODS: Subjects with BPD on chronic home ventilation were recruited from outpatient clinics. PH was defined by its presence on ≥1 cardiac catheterization or echocardiogram on or after 36 weeks post-menstrual age. Kaplan-Meier analysis was used to compare the timing of key events.
RESULTS: Of the 154 subjects, 93 (60.4%) had PH and of those, 52 (55.9%) required PH-specific medications. The ages at tracheostomy, transition to home ventilator, and hospital discharge were older in those with PH. Most subjects were weaned off oxygen and liberated from the ventilator by 5 years of age, which did not occur later in subjects with PH. The mortality rate after initial discharge was 2.6%.
CONCLUSIONS: The majority of infants with BPD-PH receiving chronic invasive ventilation at home survived after initial discharge. Subjects with BPD-PH improved over time as evidenced by weaning off oxygen and PH medications, ventilator liberation, and tracheostomy decannulation. While the presence of PH was not associated with later ventilator liberation or decannulation, the use of PH medications may be a marker of a more protracted disease trajectory.
IMPACT STATEMENT: There is limited data on long-term outcomes of children with bronchopulmonary dysplasia (BPD) who receive chronic invasive ventilation at home, and no data on those with the comorbidity of pulmonary hypertension (PH). Almost all subjects with BPD-PH who were on chronic invasive ventilation at home survived after their initial hospital discharge. Subjects with BPD-PH improved over time as evidenced by weaning off oxygen, PH medications, liberation from the ventilator, and tracheostomy decannulation. The presence of PH did not result in later ventilator liberation or decannulation; however, the use of outpatient PH medications was associated with later ventilation liberation and decannulation.
Journal Title
Pediatric research
Volume
97
Issue
1
First Page
387
Last Page
394
MeSH Keywords
Humans; Bronchopulmonary Dysplasia; Hypertension, Pulmonary; Infant; Female; Male; Respiration, Artificial; Child, Preschool; Treatment Outcome; Infant, Newborn; Patient Discharge; Home Care Services; Child; Kaplan-Meier Estimate; Tracheostomy; Ventilator Weaning
PubMed ID
39181986
Keywords
Bronchopulmonary Dysplasia; Hypertension, Pulmonary; Artificial Respiration; Treatment Outcome; Patient Discharge; Child Home Care Services; Kaplan-Meier Estimate; Tracheostomy; Ventilator Weaning
Recommended Citation
Akangire GG, Manimtim W, Agarwal A, et al. Outcomes of infants and children with bronchopulmonary dysplasia-associated pulmonary hypertension who required home ventilation. Pediatr Res. 2025;97(1):387-394. doi:10.1038/s41390-024-03495-8
