Cardiopulmonary physiological effects of diuretic therapy in preterm infants with chronic pulmonary hypertension.
Journal
Journal of perinatology : official journal of the California Perinatal Association
ISSN: 1476-5543
Titre abrégé: J Perinatol
Pays: United States
ID NLM: 8501884
Informations de publication
Date de publication:
10 2023
10 2023
Historique:
received:
04
05
2023
accepted:
27
07
2023
revised:
10
07
2023
medline:
2
10
2023
pubmed:
8
8
2023
entrez:
7
8
2023
Statut:
ppublish
Résumé
Using targeted neonatal echocardiography (TNE) to examine cardiopulmonary physiological impact of diuretics in preterm infants with chronic pulmonary hypertension (cPH). Retrospective study comparing TNE indices pre- and ≤2 weeks (post) of initiating diuretic therapy in infants born <32 weeks gestational age with cPH. Twenty-seven neonates with mean gestational age, birthweight and interval between pre-post diuretic TNE of 27.0 ± 2.8 weeks, 859 ± 294 grams, and 7.8 ± 3.0 days respectively were studied. Diuretics was associated with improvement in pulmonary vascular resistance [pulmonary artery acceleration time (PAAT); 34.27(9.76) vs. 40.24(11.10)ms, p = 0.01), right ventricular (RV) ejection time:PAAT ratio [5.92(1.66) vs. 4.83(1.14), p < 0.01)], RV fractional area change [41.6(9.8) vs. 46.4(6.5%), p = 0.03)] and left ventricular myocardial performance index [0.55(0.09) vs. 0.41(0.23), p < 0.01)]. Post-treatment, frequency of bidirectional/right-to-left inter-atrial shunts decreased significantly (24% vs. 4%, p = 0.05). Primary diuretic treatment in neonates with cPH may result in improvement in PVR, RV and LV function and compliance.
Identifiants
pubmed: 37550529
doi: 10.1038/s41372-023-01742-0
pii: 10.1038/s41372-023-01742-0
doi:
Substances chimiques
Diuretics
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1288-1294Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer Nature America, Inc.
Références
Choi EK, Shin SH, Kim EK, Kim HS. Developmental outcomes of preterm infants with bronchopulmonary dysplasia-associated pulmonary hypertension at 18–24 months of corrected age. BMC Pediatr. 2019;19:26.
doi: 10.1186/s12887-019-1400-3
pubmed: 30654786
pmcid: 6337852
Mourani PM, Abman SH. Pulmonary Hypertension and Vascular Abnormalities in Bronchopulmonary Dysplasia. Clin Perinatol. 2015;42:839–55.
doi: 10.1016/j.clp.2015.08.010
pubmed: 26593082
pmcid: 5863545
Kim DH, Kim HS, Choi CW, Kim EK, Kim BI, Choi JH. Risk factors for pulmonary artery hypertension in preterm infants with moderate or severe bronchopulmonary dysplasia. Neonatology 2012;101:40–6.
doi: 10.1159/000327891
pubmed: 21791938
Baczynski M, Bell EF, Finan E, McNamara PJ, Jain A. Survey of practices in relation to chronic pulmonary hypertension in neonates in the Canadian Neonatal Network and the National Institute of Child Health and Human Development Neonatal Research Network. Pulm Circ. 2020;10:2045894020937126.
doi: 10.1177/2045894020937126
pubmed: 32728420
pmcid: 7366415
Humbert M, Kovacs G, Hoeper MM, Badagliacca R, Berger RMF, Brida M, et al. 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Respir J. 2022;43:3618–731.
Hansmann G, Koestenberger M, Alastalo TP, Apitz C, Austin ED, Bonnet D, et al. 2019 updated consensus statement on the diagnosis and treatment of pediatric pulmonary hypertension: The European Pediatric Pulmonary Vascular Disease Network (EPPVDN), endorsed by AEPC, ESPR and ISHLT. J Heart Lung Transplant. 2019;38:879–901.
doi: 10.1016/j.healun.2019.06.022
pubmed: 31495407
Neary E, Jain A. Right ventricular congestion in preterm neonates with chronic pulmonary hypertension. J Perinatol. 2018;38:1708–10.
doi: 10.1038/s41372-018-0241-5
pubmed: 30297866
Ahmed H, VanderPluym C. Medical management of pediatric heart failure. Cardiovasc Diagn Ther. 2021;11:323–35.
doi: 10.21037/cdt-20-358
pubmed: 33708503
pmcid: 7944205
Jain A, Mohamed A, El-Khuffash A, Connelly KA, Dallaire F, Jankov RP, et al. A comprehensive echocardiographic protocol for assessing neonatal right ventricular dimensions and function in the transitional period: normative data and z scores. J Am Soc Echocardiogr. 2014;27:1293–304.
doi: 10.1016/j.echo.2014.08.018
pubmed: 25260435
Levy PT, Patel MD, Groh G, Choudhry S, Murphy J, Holland MR, et al. Pulmonary Artery Acceleration Time Provides a Reliable Estimate of Invasive Pulmonary Hemodynamics in Children. J Am Soc Echocardiogr. 2016;29:1056–65.
doi: 10.1016/j.echo.2016.08.013
pubmed: 27641101
pmcid: 5408579
Patel MD, Breatnach CR, James AT, Choudhry S, McNamara PJ, Jain A, et al. Echocardiographic Assessment of Right Ventricular Afterload in Preterm Infants: Maturational Patterns of Pulmonary Artery Acceleration Time Over the First Year of Age and Implications for Pulmonary Hypertension. J Am Soc Echocardiogr. 2019;32:884–94 e4.
doi: 10.1016/j.echo.2019.03.015
pubmed: 31272593
pmcid: 6613806
Burkett DA, Patel SS, Mertens L, Friedberg MK, Ivy DD. Relationship Between Left Ventricular Geometry and Invasive Hemodynamics in Pediatric Pulmonary Hypertension. Circ Cardiovasc Imaging. 2020;13:e009825.
doi: 10.1161/CIRCIMAGING.119.009825
pubmed: 32408829
pmcid: 7236425
Sutherland GR, Di Salvo G, Claus P, D'Hooge J, Bijnens B. Strain and strain rate imaging: a new clinical approach to quantifying regional myocardial function. J Am Soc Echocardiogr. 2004;17:788–802.
doi: 10.1016/j.echo.2004.03.027
pubmed: 15220909
Arjaans S, Fries MWF, Schoots MH, Schilte CFM, Roofthooft MTR, Vrijlandt E, et al. Clinical significance of early pulmonary hypertension in preterm infants. J Pediatr. 2022;251:P74-81.E3.
Krishnan U, Feinstein JA, Adatia I, Austin ED, Mullen MP, Hopper RK, et al. Evaluation and Management of Pulmonary Hypertension in Children with Bronchopulmonary Dysplasia. J Pediatr. 2017;188:24–34 e1.
doi: 10.1016/j.jpeds.2017.05.029
pubmed: 28645441
Mourani PM, Mandell EW, Meier M, Younoszai A, Brinton JT, Wagner BD, et al. Early Pulmonary Vascular Disease in Preterm Infants Is Associated with Late Respiratory Outcomes in Childhood. Am J Respir Crit Care Med. 2019;199:1020–7.
doi: 10.1164/rccm.201803-0428OC
pubmed: 30303395
pmcid: 6467308
Weismann CG, Asnes JD, Bazzy-Asaad A, Tolomeo C, Ehrenkranz RA, Bizzarro MJ. Pulmonary hypertension in preterm infants: results of a prospective screening program. J Perinatol. 2017;37:572–7.
doi: 10.1038/jp.2016.255
pubmed: 28206997
Levy PT, Jain A, Nawaytou H, Teitel D, Keller R, Fineman J, et al. Risk Assessment and Monitoring of Chronic Pulmonary Hypertension in Premature Infants. J Pediatr. 2020;217:199–209 e4.
doi: 10.1016/j.jpeds.2019.10.034
pubmed: 31735418
Berenz A, Vergales JE, Swanson JR, Sinkin RA. Evidence of Early Pulmonary Hypertension Is Associated with Increased Mortality in Very Low Birth Weight Infants. Am J Perinatol. 2017;34:801–7.
doi: 10.1055/s-0037-1598246
pubmed: 28201824
Mourani PM, Sontag MK, Ivy DD, Abman SH. Effects of long-term sildenafil treatment for pulmonary hypertension in infants with chronic lung disease. J Pediatr. 2009;154:379–84.
doi: 10.1016/j.jpeds.2008.09.021
pubmed: 18950791
Trottier-Boucher MN, Lapointe A, Malo J, Fournier A, Raboisson MJ, Martin B, et al. Sildenafil for the Treatment of Pulmonary Arterial Hypertension in Infants with Bronchopulmonary Dysplasia. Pediatr Cardiol. 2015;36:1255–60.
doi: 10.1007/s00246-015-1154-0
pubmed: 25824807
Tan K, Krishnamurthy MB, O'Heney JL, Paul E, Sehgal A. Sildenafil therapy in bronchopulmonary dysplasia-associated pulmonary hypertension: a retrospective study of efficacy and safety. Eur J Pediatr. 2015;174:1109–15.
doi: 10.1007/s00431-015-2515-7
pubmed: 25796626
Kadmon G, Schiller O, Dagan T, Bruckheimer E, Birk E, Schonfeld T. Pulmonary hypertension specific treatment in infants with bronchopulmonary dysplasia. Pediatr Pulmonol. 2017;52:77–83.
doi: 10.1002/ppul.23508
pubmed: 27333438
Nyp M, Sandritter T, Poppinga N, Simon C, Truog WE. Sildenafil citrate, bronchopulmonary dysplasia and disordered pulmonary gas exchange: any benefits? J Perinatol. 2012;32:64–9.
doi: 10.1038/jp.2011.131
pubmed: 21941230
Thompson EJ, Perez K, Hornik CP, Smith PB, Clark RH, Laughon M, et al. Sildenafil Exposure in the Neonatal Intensive Care Unit. Am J Perinatol. 2019;36:262–7.
doi: 10.1055/s-0038-1667378
pubmed: 30081404
Abman SH, Hansmann G, Archer SL, Ivy DD, Adatia I, Chung WK, et al. Pediatric Pulmonary Hypertension: Guidelines From the American Heart Association and American Thoracic Society. Circulation 2015;132:2037–99.
doi: 10.1161/CIR.0000000000000329
pubmed: 26534956
Hansmann G, Sallmon H, Roehr CC, Kourembanas S, Austin ED, Koestenberger M, et al. Pulmonary hypertension in bronchopulmonary dysplasia. Pediatr Res. 2021;89:446–55.
doi: 10.1038/s41390-020-0993-4
pubmed: 32521539
Baczynski M, Kelly E, McNamara PJ, Shah PS, Jain A. Short and long-term outcomes of chronic pulmonary hypertension in preterm infants managed using a standardized algorithm. Pediatr Pulmonol. 2021;56:1155–64.
MacIver DH, Clark AL. The vital role of the right ventricle in the pathogenesis of acute pulmonary edema. Am J Cardiol. 2015;115:992–1000.
doi: 10.1016/j.amjcard.2015.01.026
pubmed: 25697920
Stanford AH, Reyes M, Rios DR, Giesinger RE, Jetton JG, Bischoff AR, et al. Safety, Feasibility, and Impact of Enalapril on Cardiorespiratory Physiology and Health in Preterm Infants with Systemic Hypertension and Left Ventricular Diastolic Dysfunction. J Clin Med. 2021;10:4519.
doi: 10.3390/jcm10194519
pubmed: 34640535
pmcid: 8509219
Sehgal A, Steenhorst JJ, McLennan DI, Merkus D, Ivy D, McNamara PJ. The Left Heart, Systemic Circulation, and Bronchopulmonary Dysplasia: Relevance to Pathophysiology and Therapeutics. J Pediatr. 2020;225:13–22 e2.
doi: 10.1016/j.jpeds.2020.06.031
pubmed: 32553872
Greenberg RG, Gayam S, Savage D, Tong A, Gorham D, Sholomon A, et al. Furosemide Exposure and Prevention of Bronchopulmonary Dysplasia in Premature Infants. J Pediatr. 2019;208:134–40 e2.
doi: 10.1016/j.jpeds.2018.11.043
pubmed: 30579586
Hufnagle KG, Khan SN, Penn D, Cacciarelli A, Williams P. Renal calcifications: a complication of long-term furosemide therapy in preterm infants. Pediatrics 1982;70:360–3.
doi: 10.1542/peds.70.3.360
pubmed: 7110808
Laughon MM, Chantala K, Aliaga S, Herring AH, Hornik CP, Hughes R, et al. Diuretic exposure in premature infants from 1997 to 2011. Am J Perinatol. 2015;32:49–56.
pubmed: 24801161
Stewart A, Brion LP. Intravenous or enteral loop diuretics for preterm infants with (or developing) chronic lung disease. Coch Database Syst Rev. 2011;2011:CD001453.