Inpatient and ICU Clinical Pathway for Pulmonary Hypertension (PH) Screenings in Patients with Bronchopulmonary Dysplasia (BPD)

Patient with Suspected Diagnosis of Bronchopulmonary Dysplasia (BPD)
 
 
  • Diagnostic Criteria for BPD
    • Gestational age at birth < 32 weeks AND
    • Ongoing respiratory support at a postmenstrual age (PMA) of 36 weeks
Routine PH screening not indicated for patients without BPD; but may consider for those who develop a respiratory support requirement after 36 weeks PMA.
 
 
 
 
 
 
 
 
Grade 1 BPD
Nasal cannula ≤ 2L/min
Grade 2 BPD
Nasal cannula > 2L/min OR
Noninvasive positive airway pressure
Grade 3 BPD
Invasive mechanical ventilation
 
 
 
 
 
 
  • Obtain Echo if If any of the following are present:
    • Discharge to home on any respiratory support between
      36-40 weeks PMA
  • OR
  • Ongoing need for any degree of respiratory support at 40 weeks PMA
Obtain ECHO at 36 weeks
 
 
 
 
 
 
No Evidence for PH
Evidence for PH Present

Monthly screen while inpatient if remains on ≥ 2L/min.

Review results with local cardiologist and discuss if a formal consult to cardiology is needed to guide management including timing of repeat echocardiogram.

Posted: November 2020
Authors: C. Avitabile, MD; N. Bamat, MD; E. Eichenwald, MD; J. Fierro, MD; K. Gibbs, MD; E. Jensen, MD; K. Maschhoff, MD; H. Morris, PA-C; K. Nilan, RN ; J. Patykula, CRNP; T. Pawlowski, MD; I. Peterside, MD; L. Sillers, MD ; J. Stoller, MD