Assessing pulmonary arterial hypertension in infants with severe chronic lung disease of infancy: A role for a pulmonary artery catheter?

Orkun Baloglu, Vincent P R Aluquin, Robert F. Tamburro, Neal J. Thomas, Steven E. Lucking, Gary D. Ceneviva, Toah Nkromah, Beth R. Schneider, Emily Lewellen, Michael D. Dettorre

Research output: Contribution to journalArticle

Abstract

The treatment of pulmonary arterial hypertension (PAH) associated with chronic lung disease of infancy (CLDI) is becoming commonplace. However, an optimal approach to the monitoring of this treatment has not been clearly established, and data suggest that such therapy may not be without risk. This study assessed the feasibility and safety of pulmonary artery catheter (PAC) placement and its role in the management of PAH associated with CLDI. The medical records of 12 infants with CLDI requiring chronic mechanical ventilation who underwent PAC monitoring were reviewed. Data analyzed included demographics, hemodynamic data, PAH pharmacological therapy, respiratory support, echocardiographic data, sedation level, complications related to PAC use, and mortality. In this analysis, PAC placement and monitoring was found to be feasible, appeared safe, and was associated with the ability to wean inspired oxygen, decrease sedation, and titrate PAH therapy without untoward effect. However, no definitive conclusions can be drawn from this report given its small sample size and uncontrolled, retrospective design. It is hoped that these data will renew interest in PAC monitoring for CLDI and foster prospective study where its true value can be ascertained.

Original languageEnglish (US)
Pages (from-to)1330-1334
Number of pages5
JournalPediatric cardiology
Volume34
Issue number6
DOIs
StatePublished - Aug 1 2013

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Pulmonary Hypertension
Pulmonary Artery
Lung Diseases
Chronic Disease
Catheters
Respiratory Therapy
Feasibility Studies
Therapeutics
Artificial Respiration
Sample Size
Medical Records
Hemodynamics
Demography
Prospective Studies
Pharmacology
Oxygen
Safety
Mortality

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Assessing pulmonary arterial hypertension in infants with severe chronic lung disease of infancy: A role for a pulmonary artery catheter?",
abstract = "The treatment of pulmonary arterial hypertension (PAH) associated with chronic lung disease of infancy (CLDI) is becoming commonplace. However, an optimal approach to the monitoring of this treatment has not been clearly established, and data suggest that such therapy may not be without risk. This study assessed the feasibility and safety of pulmonary artery catheter (PAC) placement and its role in the management of PAH associated with CLDI. The medical records of 12 infants with CLDI requiring chronic mechanical ventilation who underwent PAC monitoring were reviewed. Data analyzed included demographics, hemodynamic data, PAH pharmacological therapy, respiratory support, echocardiographic data, sedation level, complications related to PAC use, and mortality. In this analysis, PAC placement and monitoring was found to be feasible, appeared safe, and was associated with the ability to wean inspired oxygen, decrease sedation, and titrate PAH therapy without untoward effect. However, no definitive conclusions can be drawn from this report given its small sample size and uncontrolled, retrospective design. It is hoped that these data will renew interest in PAC monitoring for CLDI and foster prospective study where its true value can be ascertained.",
author = "Orkun Baloglu and Aluquin, {Vincent P R} and Tamburro, {Robert F.} and Thomas, {Neal J.} and Lucking, {Steven E.} and Ceneviva, {Gary D.} and Toah Nkromah and Schneider, {Beth R.} and Emily Lewellen and Dettorre, {Michael D.}",
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T2 - A role for a pulmonary artery catheter?

AU - Baloglu, Orkun

AU - Aluquin, Vincent P R

AU - Tamburro, Robert F.

AU - Thomas, Neal J.

AU - Lucking, Steven E.

AU - Ceneviva, Gary D.

AU - Nkromah, Toah

AU - Schneider, Beth R.

AU - Lewellen, Emily

AU - Dettorre, Michael D.

PY - 2013/8/1

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N2 - The treatment of pulmonary arterial hypertension (PAH) associated with chronic lung disease of infancy (CLDI) is becoming commonplace. However, an optimal approach to the monitoring of this treatment has not been clearly established, and data suggest that such therapy may not be without risk. This study assessed the feasibility and safety of pulmonary artery catheter (PAC) placement and its role in the management of PAH associated with CLDI. The medical records of 12 infants with CLDI requiring chronic mechanical ventilation who underwent PAC monitoring were reviewed. Data analyzed included demographics, hemodynamic data, PAH pharmacological therapy, respiratory support, echocardiographic data, sedation level, complications related to PAC use, and mortality. In this analysis, PAC placement and monitoring was found to be feasible, appeared safe, and was associated with the ability to wean inspired oxygen, decrease sedation, and titrate PAH therapy without untoward effect. However, no definitive conclusions can be drawn from this report given its small sample size and uncontrolled, retrospective design. It is hoped that these data will renew interest in PAC monitoring for CLDI and foster prospective study where its true value can be ascertained.

AB - The treatment of pulmonary arterial hypertension (PAH) associated with chronic lung disease of infancy (CLDI) is becoming commonplace. However, an optimal approach to the monitoring of this treatment has not been clearly established, and data suggest that such therapy may not be without risk. This study assessed the feasibility and safety of pulmonary artery catheter (PAC) placement and its role in the management of PAH associated with CLDI. The medical records of 12 infants with CLDI requiring chronic mechanical ventilation who underwent PAC monitoring were reviewed. Data analyzed included demographics, hemodynamic data, PAH pharmacological therapy, respiratory support, echocardiographic data, sedation level, complications related to PAC use, and mortality. In this analysis, PAC placement and monitoring was found to be feasible, appeared safe, and was associated with the ability to wean inspired oxygen, decrease sedation, and titrate PAH therapy without untoward effect. However, no definitive conclusions can be drawn from this report given its small sample size and uncontrolled, retrospective design. It is hoped that these data will renew interest in PAC monitoring for CLDI and foster prospective study where its true value can be ascertained.

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