title: Echocardiographic detection of pulmonary hypertension in extremely low birth weight infants with bronchopulmonary dysplasia requiring prolonged positive pressure ventilation.
abstract: OBJECTIVE
  The goal of this study was to delineate the epidemiology of echocardiographically diagnosed pulmonary hypertension (PH) in extremely low birth weight (ELBW) infants with bronchopulmonary dysplasia (BPD) requiring prolonged positive pressure ventilation (PPV), and to determine the independent relationship between PH and mortality in these patients.
  
  
  METHODS
  Our retrospective cohort included ELBW infants, with BPD requiring prolonged PPV, hospitalized in Cincinnati, Ohio during 2003-2009, as recorded in the National Institute of Child Health and Human Development Neonatal Research Network Database. Following chart review, a logistic regression model was constructed to understand the contribution of PH to mortality in infants with BPD requiring prolonged PPV.
  
  
  RESULTS
  We identified 216 patients (19%) with BPD requiring prolonged PPV among 1156 ELBW infants. Of these patients, 41% received echocardiography after 4 weeks of life, with 37% showing evidence of PH. Logistic regression analysis demonstrated that infants with BPD requiring prolonged PPV, with PH detectable by echocardiogram, were four times more likely to die (adjusted odds ratio): 4.6, 95% confidence interval: 1.3-16.5) when compared with infants with BPD requiring prolonged PPV without echocardiographic evidence of PH.
  
  
  CONCLUSIONS
  Pulmonary hypertension appears to be an important, independent determinant of death in infants with BPD requiring prolonged PPV.
authors.affiliation: The Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
authors.forename: J L
authors.initials: JL
authors.lastname: Slaughter
authors.forename: T
authors.initials: T
authors.lastname: Pakrashi
authors.forename: D E
authors.initials: DE
authors.lastname: Jones
authors.forename: A P
authors.initials: AP
authors.lastname: South
authors.forename: T A
authors.initials: TA
authors.lastname: Shah
mesh_terms: D001997:Bronchopulmonary Dysplasia / Q000150:complications / Q000628:therapy*; D004452:Echocardiography; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000000981:diagnostic imaging* / Q000401:mortality; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000000981:diagnostic imaging / Q000628:therapy; D008297:Male; D011175:Positive-Pressure Respiration