Pulmonary Hypertension Screening in Patients with Bronchopulmonary Dysplasia Clinical Pathway — ICU and Inpatient
Pulmonary Hypertension Screening in Patients with Bronchopulmonary Dysplasia Clinical Pathway — ICU and Inpatient
Echocardiogram Screening and Evidence of Pulmonary Hypertension
Considerations for Echocardiogram Screening
- Infants with BPD are at risk for pulmonary hypertension. The development of pulmonary hypertension contributes to the higher rates of morbidity and mortality in this population.
- Routine PH screening is not indicated for premature infants at 36 weeks PMA without BPD.
- If an infant without BPD develops signs and symptoms that may be consistent with PH, including the development of a need for respiratory support after 36 weeks PMA, consider obtaining an echocardiogram as PH may be present in these infants.
- BNP is not indicated as part of the screening process for PH.
- There are some limitations in the use of echocardiogram as a screening test for PH, and the timing of disease development is not entirely understood.
- Incidence of PH is highest in infants with grade 2-3 BPD; therefore, repeat screens are recommended regularly for this subset of infants with BPD.
- PH in patients with BPD can develop after 36 weeks PMA.
Evidence of PH |
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Supporting Evidence |
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Role of Cardiology Consultation
- Formal consultation can be determined by local routine and obtain guidance on need for treatment, additional testing or follow-up.
- For an echocardiogram obtained close to discharge, completion of cardiology consultation could occur as outpatient if an option for outpatient follow-up is available.