Risk Factors, Diagnosis, Screening and Therapy of Pulmonary Hypertension in Children with Bronchopulmonary Dysplasia
D.Yu. Ovsyannikov, Moscow, Russian Federation, Elena A. Degtyareva, V.P. Miroshnichenko, V.A. Strellnikova, M.A. Abramyan
Abstract
D.Yu. Ovsyannikov, Moscow, Russian Federation, Elena A. Degtyareva, V.P. Miroshnichenko, V.A. Strellnikova, M.A. Abramyan
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. Keywords: bronchopulmonary dysplasia, pulmonary hypertension, chronic pulmonary hypertension in infants, diagnosis, therapy.
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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. Keywords: bronchopulmonary dysplasia, pulmonary hypertension, chronic pulmonary hypertension in infants, diagnosis, therapy.
Key concepts: Bronchopulmonary dysplasia, Medicine, Pulmonary hypertension, Oxygen therapy, Sildenafil, Pulmonary artery, Complication, Dysplasia