Babies with BPD frequently have some degree of pulmonary hypertension, which may lead to right ventricular dysfunction. Arvind Seghal and colleagues studied 18 infants with severe BPD and 10 preterms without at 36 weeks post-menstrual age. Multiple echocardiographic indices were measured to evaluate RV function, including tissue doppler indices. RV function was impaired in the infants with BPD, and correlated with the duration of respiratory support, 13 of the babies when home on oxygen.
Villeneuve A, et al. Echocardiographic Right Ventricular Pressure Ratio Correlates with Prolonged Oxygen Therapy in Patients with Moderate to Severe Bronchopulmonary Dysplasia. Annals of Pediatrics and Child Health. 2015;3(9). In a similar study from our hospital, we concentrated on measures of pulmonary hypertension, 29 babies with moderate or severe BPD were enrolled around 36 weeks of age. We found that the most predictive measure for prolonged oxygen therapy was the right ventricular pre-ejection period/ejection time ratio [RVPEP/RVET].
Evaluation of pulmonary hypertension and of right ventricular function can help to predict duration of oxygen therapy, and could perhaps be used to screen patients for controlled trials of newer therapies such as sildenafil.