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Assessing the role of tracheostomy placement in bronchopulmonary dysplasia with pulmonary hypertension

Journal of Perinatology (2024)Cite this article

Subjects

Abstract

Objective

Bronchopulmonary dysplasia (BPD) is a common complication of preterm birth and is associated with abnormal vasculature that contributes to pulmonary hypertension (PH). We evaluated how a tracheostomy may alter PH in these patients.

Methods

A retrospective chart review over 15-years identified 17 patients with BPD and PH who underwent tracheostomy. Each patient had four echocardiograms re-reviewed and scored for tricuspid valve regurgitation velocity (TR), tricuspid annular plane systolic excursion (TAPSE), right atrial cross-sectional area (RACA), and left ventricle eccentricity indices (EI).

Result

There was improvement in TR, TAPSE, RACA, and left ventricle EI indicating reduction in PH after tracheostomy.

Conclusion

PH improves over time though role of tracheostomy in PH needs to be further defined. The EI may be a sensitive marker to follow over time in these patients.

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Fig. 1: Flow diagram for patient selection.
Fig. 2: Spaghetti plot for individual patients showing changes in ECHO parameters over time.
Fig. 3: Change in ECHO parameters over time.

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Authors and Affiliations

  1. Children’s Hospital Los Angeles, Los Angeles, CA, USA

    Timothy D. Hicks, Julian Cameron, Shuo Wang, Jacqueline Szmuszkovicz, Narayan Iyer & Manvi Bansal

  2. Children’s Hospital Orange County, Orange, CA, USA

    Timothy D. Hicks & Amir Ashrafi

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Contributions

Timothy D. Hicks: Conceptualization, methodology, formal analysis, investigation, writing – original draft preparation, writing—review and editing. Julian Cameron: Methodology, investigation. Shuo Wang: Conceptualization, writing—review and editing, Amir Ashrafi: Conceptualization, methodology, writing—review and editing, Jacqueline Szmuszkovicz: Conceptualization, methodology, writing—review and editing, Narayan Iyer: Conceptualization, methodology, formal analysis, writing—review and editing. Manvi Bansal: Supervision, Conceptualization, methodology, formal analysis, investigation, writing – review and editing.

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Correspondence to Timothy D. Hicks.

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The authors declare no competing interests.

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The study was approved by the CHLA IRB: Study ID Number: CHLA-21-00031.

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Hicks, T.D., Cameron, J., Wang, S. et al. Assessing the role of tracheostomy placement in bronchopulmonary dysplasia with pulmonary hypertension. J Perinatol (2024). https://doi.org/10.1038/s41372-024-01881-y

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