title: Assessing pulmonary arterial hypertension in infants with severe chronic lung disease of infancy: a role for a pulmonary artery catheter?
abstract: The treatment of pulmonary arterial hypertension (PAH) associated with chronic lung disease of infancy (CLDI) is becoming commonplace. However, an optimal approach to the monitoring of this treatment has not been clearly established, and data suggest that such therapy may not be without risk. This study assessed the feasibility and safety of pulmonary artery catheter (PAC) placement and its role in the management of PAH associated with CLDI. The medical records of 12 infants with CLDI requiring chronic mechanical ventilation who underwent PAC monitoring were reviewed. Data analyzed included demographics, hemodynamic data, PAH pharmacological therapy, respiratory support, echocardiographic data, sedation level, complications related to PAC use, and mortality. In this analysis, PAC placement and monitoring was found to be feasible, appeared safe, and was associated with the ability to wean inspired oxygen, decrease sedation, and titrate PAH therapy without untoward effect. However, no definitive conclusions can be drawn from this report given its small sample size and uncontrolled, retrospective design. It is hoped that these data will renew interest in PAC monitoring for CLDI and foster prospective study where its true value can be ascertained.
authors: Department of Pediatrics, Division of Pediatric Critical Care Medicine, Penn State Hershey Children's Hospital, Pennsylvania State University College of Medicine, 500 University Drive, Hershey, PA 17033, USA.
authors: Orkun
authors: O
authors: Baloglu
authors: Vincent P R
authors: VP
authors: Aluquin
authors: Robert F
authors: RF
authors: Tamburro
authors: Neal J
authors: NJ
authors: Thomas
authors: Steven E
authors: SE
authors: Lucking
authors: Gary D
authors: GD
authors: Ceneviva
authors: Toah
authors: T
authors: Nkromah
authors: Beth R
authors: BR
authors: Schneider
authors: Emily
authors: E
authors: Lewellen
authors: Michael D
authors: MD
authors: Dettorre
mesh_terms: D002407:Catheterization, Swan-Ganz / Q000379:methods*; D002908:Chronic Disease; D004452:Echocardiography; D065627:Familial Primary Pulmonary Hypertension; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000175:diagnosis* / Q000503:physiopathology; D008171:Lung Diseases / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D008297:Male; D011446:Prospective Studies; D011651:Pulmonary Artery; D015203:Reproducibility of Results; D012720:Severity of Illness Index