Raised pulmonary artery pressure in very low birthweight infants requiring supplemental oxygen at 36 weeks after conception

Abstract

This study aimed to investigate the changes in pulmonary artery pressure in infants with chronic lung disease who then developed prolonged oxygen dependency. The time to peak velocity:right ventricular ejection time (TPV:RVET) ratio calculated from the Doppler waveform, which correlates negatively with pulmonary artery pressure, was used. Thirty four infants with chronic lung disease were studied. At 36 weeks after conception 19 infants still required supplemental oxygen (POD group) and 16 infants were in air (controls). Over the first three weeks, there was a significant rise in the ratio in both groups, indicating a fall in pulmonary arterial pressure. From the third week onwards the ratio was significantly lower in the POD group. There was a significant rise in the ratio from four to 36 weeks after conception in the control group; the POD group showed a tendency towards a fall over the same time period. The requirement for supplemental oxygen almost mirrored the changes in the ratio in both groups but was not significantly different until the fifth week after birth. These data suggest that pulmonary arterial pressure has a significant role in the pathophysiology of prolonged oxygen dependency and may be important in the subsequent morbidity associated with this group of very low birthweight infants.