Pulmonary Hypertension Screening in Patients with Bronchopulmonary Dysplasia Clinical Pathway — ICU and Inpatient
ECHO Screening and ECHO Evidence ECHO of Pulmonary Hypertension
Considerations for ECHO 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 on a regular basis for this subset of infants with BPD.
- PH in patients with BPD can develop after 36 weeks PMA.
Evidence of PH |
|
---|---|
Supporting Evidence |
|
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 that is obtained close to discharge, completion of cardiology consultation could occur as outpatient if an option for outpatient follow up is available.