Pulmonary artery pressure: early predictor of chronic lung disease in preterm infants
a Department of Child Health, University of Liverpool, b Regional Neonatal
Intensive Care Unit, Liverpool Women's Hospital
Correspondence to: Dr N V Subhedar, Regional Neonatal Intensive Care Unit, Liverpool Women's Hospital, Liverpool L8 7SS.
Accepted 29 May 1997
AIM
To determine if pulmonary artery pressure
(PAP) in ventilated preterm infants is independently associated with
the development of chronic lung disease (CLD) and whether early
assessment has any prognostic value.
METHODSTwo cohorts (development n = 55; and
validation n = 28) of preterm infants were studied at 24 hours of age.
PAP was assessed non-invasively using its inverse correlation with the
corrected acceleration time to right ventricular ejection time ratio
(AT:RVET(c)), calculated from the pulmonary artery Doppler waveform.
Clinical and respiratory variables were also collected. Using logistic regression analysis to identify factors independently associated with
CLD, a prognostic score was developed to predict CLD. The ability of
the score to predict CLD was described using receiver operating
characteristic (ROC) curves.
RESULTSBirthweight, inspired oxygen
concentration, and AT:RVET(c) were independently predictive of CLD. The
area under the ROC curve was 0.96 for the development and 0.89 for the
validation cohort. Exclusion of AT:RVET(c) resulted in a reduction to
0.88 and 0.73, respectively.
CONCLUSIONPAP is independently associated with
CLD. An early assessment of PAP using AT:RVET(c) may permit the early
prediction of CLD as part of a multifactorial scoring system.
© 1998 by Archives of Disease in Childhood
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