title: Oxygen requirement as a screening tool for the detection of late pulmonary hypertension in extremely low birth weight infants.
abstract: BACKGROUND
  Many extremely low birth weight infants develop pulmonary hypertension late in their clinical course, and over 60% go undetected by early screening echocardiography. At present, no standardised screening protocol exists for detecting late pulmonary hypertension in extremely low birth weight infants. We assessed the utility of oxygen supplementation as a predictor of late pulmonary hypertension.
  
  
  METHODS
  A retrospective single-centre review of extremely low birth weight infants with no evidence of CHD and those surviving for >30 days was performed. The association between oxygen ⩾30% at day of life 30 and diagnosis of late pulmonary hypertension was estimated with an odds ratio and 95% confidence interval using logistic regression. Doppler echocardiography was used to diagnose pulmonary hypertension in the infants.
  
  
  RESULTS
  A total of 230 infants met the study criteria. The incidence of late pulmonary hypertension was 8.3% (19/230). Infants with late pulmonary hypertension were more likely to have a lower mean birth weight (667.1±144 versus 799.3±140 g, p=0.001) and more likely to be small for gestational age (47.4 versus 14.2%, p=0.004). Oxygen requirement ⩾30% at day of life 30 was associated with increased risk of late pulmonary hypertension (odds ratio=3.77, 95% confidence interval=1.42-10.00, p=0.008) in univariate analysis and after adjusting for birth weight (odds ratio=2.47, 95% confidence interval=0.89-6.84, p=0.08).
  
  
  CONCLUSIONS
  The need of oxygen supplementation ⩾30% at day of life 30 may be a good screening tool for detecting late pulmonary hypertension in extremely low birth weight infants.
authors.affiliation: 1Department of Pediatrics,University of South Florida Morsani College of Medicine,Tampa,Florida,United States of America.
authors.forename: Rohit
authors.initials: R
authors.lastname: Aswani
authors.affiliation: 1Department of Pediatrics,University of South Florida Morsani College of Medicine,Tampa,Florida,United States of America.
authors.forename: Lisa
authors.initials: L
authors.lastname: Hayman
authors.affiliation: 1Department of Pediatrics,University of South Florida Morsani College of Medicine,Tampa,Florida,United States of America.
authors.forename: Gina
authors.initials: G
authors.lastname: Nichols
authors.affiliation: 1Department of Pediatrics,University of South Florida Morsani College of Medicine,Tampa,Florida,United States of America.
authors.forename: Angel A
authors.initials: AA
authors.lastname: Luciano
authors.affiliation: 3Clinical and Translational Research Organization,Johns Hopkins All Children's Hospital,St Petersburg,Florida,United States of America.
authors.forename: Ernest K
authors.initials: EK
authors.lastname: Amankwah
authors.affiliation: 3Clinical and Translational Research Organization,Johns Hopkins All Children's Hospital,St Petersburg,Florida,United States of America.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Leshko
authors.affiliation: 1Department of Pediatrics,University of South Florida Morsani College of Medicine,Tampa,Florida,United States of America.
authors.forename: Gul H
authors.initials: GH
authors.lastname: Dadlani
mesh_terms: D001724:Birth Weight; D001997:Bronchopulmonary Dysplasia / Q000150:complications / Q000453:epidemiology*; D015150:Echocardiography, Doppler; D005260:Female; D005431:Florida; D005865:Gestational Age; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis*; D015994:Incidence; D007223:Infant; D007226:Infant Mortality; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D016015:Logistic Models; D008297:Male; D015997:Neonatal Screening / Q000379:methods*; D016017:Odds Ratio; D010100:Oxygen / Q000008:administration & dosage*; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D010100:Oxygen
keywords: Pulmonary hypertension; bronchopulmonary dysplasia; echocardiography; extremely low birth weight infants; oxygen requirement; screening test