Risk Factors, Diagnosis, Screening and Therapy of Pulmonary Hypertension in Children with Bronchopulmonary Dysplasia
https://doi.org/10.31550/1727-2378-2022-21-7-12-19
Abstract
Objective of the Review: on the basis of domestic and foreign conciliation documents and the results of our own research, to present up-to date information about a dangerous complication of bronchopulmonary dysplasia - pulmonary hypertension.
Key Points: pulmonary hypertension is a common complication of bronchopulmonary dysplasia, which has antenatal, perinatal and postnatal risk factors. The presence of risk factors, respiratory failure, bronchial obstruction in a child with bronchopulmonary dysplasia is the basis for excluding pulmonary hypertension by echocardiography, which allows to detect an increase in pressure in the pulmonary artery, indirect signs of pulmonary hypertension. An obligatory method of treatment of pulmonary hypertension in children with bronchopulmonary dysplasia is oxygen therapy. With insufficient effectiveness of oxygen therapy, treatment is sequentially carried out with sildenafil, bosentan, and nitric oxide.
Conclusion: Since the clinical manifestations of pulmonary hypertension in children with bronchopulmonary dysplasia are indistinguishable from the symptoms of the underlying lung disease, timely screening of this complication and the appointment of therapy are necessary.
About the Authors
D. Yu. OvsyannikovRussian Federation
6 Miklouho-Maclay St., Moscow, 117198
1/9 4-y Dobrynenskiy per., Moscow, 119049
E. A. Degtyareva
Russian Federation
6 Miklouho-Maclay St., Moscow, 117198
V. P. Miroshnichenko
Russian Federation
1/9 4-y Dobrynenskiy per., Moscow, 119049
V. A. Strellnikova
Russian Federation
6 Miklouho-Maclay St., Moscow, 117198
M. A. Abramyan
Russian Federation
6 Miklouho-Maclay St., Moscow, 117198
1/9 4-y Dobrynenskiy per., Moscow, 119049
References
1. Ovsyannikov D.Yu., Geppe N.A., Malakhov A.B., Degtyareva D.N., ed. Bronchopulmonary dysplasia. М.; 2020. 175 p. (in Russian). URL: https://www.gastroscan.ru/literature/pdf/bronkholyogochnaya-displaziya-2020.pdf
2. Higgins R.D., Jobe A.H., Koso-Thomas M., Bancalari E. et al. Bronchopulmonary dysplasia: executive summary of a workshop. J. Pediatr. 2018; 197: 300–8. DOI: 10.1016/j.jpeds.2018.01.043
3. Heath D., Edwards J.E. The pathology of hypertensive pulmonary vascular disease; a description of six grades of structural changes in the pulmonary arteries with special reference to congenital cardiac septal defects. Circulation. 1958; 18 (4, part 1): 533–47. DOI: 10.1161/01.cir.18.4.533
4. Abman S.H., Collaco J.M., Shepherd E.G., Keszler M. et al.; Broncho pulmonary Dysplasia Collaborative. Interdisciplinary care of children with severe bronchopulmonary dysplasia. J. Pediatr. 2017; 181: 12–28.e1. DOI: 10.1016/j.jpeds.2016.10.082. Epub. 2016 Nov. 28.
5. Levy P.T., Jain A., Nawaytou H., Teitel D.et al.; Pediatric Pulmonary Hypertension Network (PPHNet). 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. Epub. 2019 Nov. 14.
6. Del Cerro M.J., Abman S., Diaz G., Freudenthal A.H. et al. A consensus approach to the classification of pediatric pulmonary hypertensive vascular disease: Report from the PVRI Pediatric Taskforce, Panama 2011. Pulm. Circ. 2011; 1(2): 286–98. DOI: 10.4103/2045 8932.83456
7. Abman S.H., Hansmann G., Archer S.L., Ivy D.D. et al.; American Heart Association Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation; Council on Clinical Cardiology; Council on Cardiovascular Disease in the Young; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Surgery and Anesthesia; the American Thoracic Society. Pediatric pulmonary hypertension: Guidelines from the American Heart Association and American Thoracic Society. Circulation. 2015; 132(21): 2037–99. DOI: 10.1161/CIR.0000000000000329
8. Krishnan U., Feinstein J.A., Adatia I., Austin E.D. et al.; Pediatric Pulmonary Hypertension Network (PPHNet). 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
9. Burov A.A., Prutkin M.E., Grebennikov V.A., Romanenko K.V. et al. Project clinical practice guideline for persistent pulmonaty hypertension of the newborn: diagnostics and therapy. Neonatology: news, opinions, training. 2014; 1(3): 145–60. (in Russian). URL: https://cyberleninka.ru/article/n/proekt-klinicheskogo-protokolapo-diagnostike-i-terapii-persistiruyushey-legochnoy-gipertenziinovorozhdennyh/viewer
10. Hansmann G., Sallmon H., Roehr C.C., Kourembanas S. et al.; European Pediatric Pulmonary Vascular Disease Network (EPPVDN). Pulmonary hypertension in bronchopulmonary dysplasia. Pediatr. Res. 2021; 89(3): 446–55. DOI: 10.1038/s41390-020-0993-4. Epub. 2020 Jun. 10.
11. Arjaans S., Zwart E.A.H., Ploegstra M.-J., Bos A.F. et al. Identification of gaps in the current knowledge on pulmonary hypertension in extremely preterm infants: A systematic review and meta-analysis. Paediatr. Perinat. Epidemiol. 2018; 32(3): 258–67. DOI: 10.1111/ppe.12444
12. Degtyareva E.A., Ovsyannikov D.Yu., Zaytseva N.O., Shokin A.A. Pulmonary hypertension and cor pulmonale in children with bronchopulmonary dysplasia: risk factors, diagnosis, treatment and prevention options. Pediatriya — Zhurnal im G.N. Speranskogo. 2013; 92(5): 32–9. (in Russian).
13. Vayalthrikkovil S., Vorhies E., Stritzke A., Bashir R.A. et al. Prospective study of pulmonary hypertension in preterm infants with bronchopulmonary dysplasia. Pediatr. Pulmonol. 2019; 54(2): 171–8. DOI: 10.1002/ppul.24211. Epub. 2018 Dec.
14. Trapeznikova A.Yu., Petrova N.A., Obraztsova G.I., Boytsova E.V. et al. Episodes of apnea and periodic breathing in premature infants with BPD-associated pulmonary hypertension. Russian Bulletin of Perinatology and Pediatrics. 2022; 67(2): 94–9. (in Russian). DOI: 10.21508/1027-4065-2022-67-2-94-99
15. Arjaans S., Haarman M.G., Roofthooft M.T.R., Fries M.W.F. et al. Fate of pulmonary hypertension associated with bronchopulmonary dysplasia beyond 36 weeks postmenstrual age. Arch. Dis. Child Fetal Neonatal Ed. 2021; 106(1): 45–50. DOI: 10.1136/archdischild-2019-318531. Epub. 2020 Jun. 22.
16. Goss K. Long-term pulmonary vascular consequences of perinatal insults. J. Physiol. 2019; 597(4): 1175–84. DOI: 10.1113/JP275859. Epub 2018 Aug. 24.
17. Levy P.T., Levin J., Leeman K.T., Mullen M.P. et al. Diagnosis and management of pulmonary hypertension in infants with bronchopulmonary dysplasia. Semin. Fetal Neonatal Med. 2022; 27(4): 101351. DOI: 10.1016/j.siny.2022.101351
18. Lince-Varela R., Restrepo D., Lince M., Muñoz D. et al. Complicaciones relacionadas con el cateterismo cardíaco pediátrico y cardiopatías congénitas. Arch. Cardiol. Mex. 2021; 91(4): 422–30. DOI: 10.24875/ACM.200003191
19. O'Byrne M.L., Kennedy K.F., Kanter J.P., Berger J.T. et al. Risk factors for major early adverse events related to cardiac catheterization in children and young adults with pulmonary hypertension: An analysis of data from the IMPACT (Improving Adult and Congenital Treatment) Registry. J. Am. Heart Assoc. 2018; 7(5): e008142. DOI: 10.1161/JAHA.117.008142
20. O'Byrne M.L., Glatz A.C., Hanna B.D., Shinohara R.T. et al. Predictors of catastrophic adverse outcomes in children with pulmonary hypertension undergoing cardiac catheterization: a multi-institutional analysis from the pediatric health information systems database. J. Am. Coll. Cardiol. 2015; 66(11): 1261–9. DOI: 10.1016/j.jacc.2015.07.032
21. Altit G., Dancea A., Renaud K., Perreault T. et al. Pathophysiology, screening and diagnosis of pulmonary hypertension in infants with bronchopulmonary dysplasia. A review of the literature. Neonatology: news, opinions, training. 2017; 1(15): 24–38. (in Russian).
22. Neklyudova G.V. Echocardiography in pulmonary hypertension. In: Avdeev S.N., ed. Pulmonary hypertension. M.; 2019: 115–41. (in Russian).
23. Mourani P.M., Sontag M.K., Younoszai A., Ivy D.D. et al. Clinical utility of echocardiography for the diagnosis and management of pulmonary vascular disease in young children with chronic lung disease. Pediatrics. 2008; 121(2): 317–25. DOI: 10.1542/peds.2007-1583
24. O'Leary J.M., Assad T.R., Xu M., Farber-Eger E. et al. Lack of a tricuspid regurgitation Doppler signal and pulmonary hypertension by invasive measurement. J. Am. Heart Assoc. 2018; 7(13): e009362. DOI: 10.1161/JAHA.118.009362
25. Galiè N., Hoeper M.M., Humbert M., Torbicki A. et al.; ESC Committee for Practice Guidelines (CPG). Guidelines for the diagnosis and treatment of pulmonary hypertension: the Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS), endorsed by the International Society of Heart and Lung Transplantation (ISHLT). Eur. Heart J. 2009; 30(20): 2493–537. DOI: 10.1093/eurheartj/ehp297
26. Abman S.H. Approach to the Child with pulmonary hypertension and bronchopulmonary dysplasia. Adv. Pulm. Hypertens. 2011; 10(2): 98–103. DOI: 10.21693/1933-088X-10.2.98
27. Coleman R.D., Chartan C.A., Mourani P.M. Intensive care management of right ventricular failure and pulmonary hypertension crises. Pediatr. Pulmonol. 2021; 56(3): 636–48. DOI: 10.1002/ppul.24776
28. Mahgoub L., Kaddoura T., Kameny A.R., Ortego P.L. et al. Pulmonary vein stenosis of ex-premature infants with pulmonary hypertension and bronchopulmonary dysplasia, epidemiology, and survival from a multicenter cohort. Pediatr. Pulmonol. 2017; 52(8): 1063–70. DOI: 10.1002/ppul.23679
29. Länger F., Werlein C., Soudah B., Schwerk N. et al. Interstitial lung disease in infancy and early childhood. Pathologe. 2021; 42(1): 25–34. DOI: 10.1007/s00292-020-00884-8
30. Vincent M., Karolak J.A., Deutsch G., Gambin T. et al. Clinical, histopathological, and molecular diagnostics in lethal lung developmental disorders. Am. J. Respir. Crit. Care Med. 2019; 200(9): 1093–101. DOI: 10.1164/rccm.201903-0495TR
31. Sasaki E., Byrne A.T., Phelan E., Cox D.W. et al. A review of filamin A mutations and associated interstitial lung disease. Eur. J. Pediatr. 2019; 178(2): 121–9. DOI: 10.1007/s00431-018-3301-0. Epub. 2018 Dec. 13.
32. Ovsyannikov D.Yu., Kotlukova N.P., Telezhnikova N.D., Trunina I.I. et al. Diseases associated with mutations in the filamin A gene: the difficult path to diagnosis (two clinical cases). Pediatriya — Zhurnal im. G.N. Speranskogo. 2022; 101(1): 202–8. (in Russian). DOI: 10.24110/0031-403X-2022-101-1-202-208
33. Steinhorn R.H., Cox P.N., Fineman J.R., Finer N.N. et al. Inhaled nitric oxide enhances oxygenation but not survival in infants with alveolar capillary dysplasia. J. Pediatr. 1997; 130(3): 417–22. DOI: 10.1016/s0022-3476(97)70203-8
34. Hansmann G., Koestenberger M., Alastalo T.P., Apitz C. 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(9): 879–901. DOI: 10.1016/j.healun.2019.06.022
35. Malloy K.W., Austin E.D. Pulmonary hypertension in the child with bronchopulmonary dysplasia. Pediatr. Pulmonol. 2021; 56(11): 3546–56. DOI: 10.1002/ppul.25602
36. Hilgendorff A., Apitz C., Bonnet D., Hansmann G. Pulmonary hypertension associated with acute or chronic lung diseases in the preterm and term neonate and infant. The European Paediatric Pulmonary Vascular Disease Network, endorsed by ISHLT and DGPK. Heart. 2016; 102 (suppl. 2): ii49–56. DOI: 10.1136/heartjnl-2015-308591
37. Gibbs K., Jensen E.A., Alexiou S., Munson D. et al. Ventilation strategies in severe bronchopulmonary dysplasia. NeoReviews. 2020; 21(4): e226–37. DOI: 10.1542/neo.21-4-e226
38. Wu K.Y., Jensen E.A.,White A.M., Wang Y. et al. Characterization of disease phenotype in very preterm infants with severe bronchopulmonary dysplasia. Am. J. Respir. Crit. Care Med. 2020; 201(11): 1398–406. DOI: 10.1164/rccm.201907-1342OC
39. Miklashevich I.M., Shkolnikova М.А., Gorbachevsky S.V., Schmaltz A.A. et al. Contemporary strategy of pulmonary hypertension management in pediatrics. Cardiovascular Therapy and Prevention. 2018; 17(2): 101–24. (in Russian). DOI: 10.15829/1728880020182101124
40. Mourani P.M., Sontag M.K., Ivy D.D., Abman S.H. Effects of long term sildenafil treatment for pulmonary hypertension in infants with chronic lung disease. J. Pediatr. 2009; 154(3): 379–84, 384.e1–2. DOI: 10.1016/j.jpeds.2008.09.021. Epub. 2008 Oct. 31.
41. Ferdman D.J., Rosenzweig E.B., Zuckerman W.A., Krishnan U. Subcutaneous treprostinil for pulmonary hypertension in chronic lung disease of infancy. Pediatrics. 2014; 134(1): e274–8. DOI: 10.1542/peds.2013-2330
42. Hansen T.P., Noel-MacDonnell J., Kuckelman S., Norberg M. et al. A multidisciplinary chronic lung disease team in a neonatal intensive care unit is associated with increased survival to discharge of infants with tracheostomy. J. Perinatol. 2021; 41(8): 1963–71. DOI: 10.1038/s41372-021-00974-2
43. Mourani P.M., Mandell E.W., Meier M., Younoszai A. Early pulmonary vascular disease in preterm infants is associated with late respiratory outcomes in childhood. Am. J. Respir. Crit. Care Med. 2019; 199(8): 1020–27. DOI: 10.1164/rccm.201803-0428OC
44. Choi E.K., Shin S.H., Kim E.-K., Kim H.-S. Developmental outcomes of preterm infants with bronchopulmonary dysplasia-associated pulmonary hypertension at 18–24 months of corrected age. BMC Pediatr. 2019; 19(1): 26. DOI: 10.1186/s12887-019-1400-3
Review
For citations:
Ovsyannikov D.Yu., Degtyareva E.A., Miroshnichenko V.P., Strellnikova V.A., Abramyan M.A. Risk Factors, Diagnosis, Screening and Therapy of Pulmonary Hypertension in Children with Bronchopulmonary Dysplasia. Title. 2022;21(7):12-19. (In Russ.) https://doi.org/10.31550/1727-2378-2022-21-7-12-19