J Perinatol
. 2021 Mar 1. doi: 10.1038/s41372-021-00923-z. Online ahead of print.
Treatment of pulmonary hypertension during initial hospitalization in a multicenter cohort of infants with congenital diaphragmatic hernia (CDH)
Ruth B Seabrook 1, Theresa R Grover 2, Natalie Rintoul 3, Mark Weems 4, Sarah Keene 5, Beverly Brozanski 6, Robert DiGeronimo 7, Beth Haberman 8, Holly Hedrick 3, Jason Gien 2, Noorjahan Ali 9, Rachel Chapman 10, John Daniel 11, H Allen Harrison 12, Yvette Johnson 13, Nicolas F M Porta 14, Michael Uhing 15, Isabella Zaniletti 16, Karna Murthy 14, Children’s Hospitals Neonatal Consortium Congenital Diaphragmatic Hernia Focus GroupAffiliations expand
- PMID: 33649432
- DOI: 10.1038/s41372-021-00923-z
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Abstract
Objective: Describe inpatient pulmonary hypertension (PH) treatment and factors associated with therapy at discharge in a multicenter cohort of infants with CDH.
Methods: Six years linked records from Children’s Hospitals Neonatal Database and Pediatric Health Information System were used to describe associations between prenatal/perinatal factors, clinical outcomes, echocardiographic findings and PH medications (PHM), during hospitalization and at discharge.
Results: Of 1106 CDH infants from 23 centers, 62.8% of infants received PHM, and 11.6% of survivors were discharged on PHM. Survivors discharged on PHM more frequently had intrathoracic liver, small for gestational age, and low 5 min APGARs compared with those discharged without PHM (p < 0.0001). Nearly one-third of infants discharged without PHM had PH on last inpatient echo.
Conclusions: PH medication use is common in CDH. Identification of infants at risk for persistent PH may impact ongoing management. Post-discharge follow-up of all CDH infants with echocardiographic evidence of PH is warranted.
