Pulmonary Hypertension Screening in Patients with Bronchopulmonary Dysplasia Clinical Pathway — ICU and Inpatient

Clinical Pathways Home Emergency ICU Inpatient Outpatient Specialty Care Primary Care

Related Pathway
BPD, Post-N/IICU, Inpatient

Patient with Suspected Diagnosis of Bronchopulmonary Dysplasia (BPD)

Diagnostic Criteria for BPD
- Gestational age at birth < 32 weeks and
- Ongoing respiratory support at a postmenstrual age (PMA) of 36 weeks

Routine PH screening not indicated for patients without BPD; but may consider for those who develop a respiratory support requirement after 36 weeks PMA.

Grade Severity of BPD if Criteria Met

Grade 1 BPD
Nasal cannula ≤ 2L/min

Grade 2 BPD
Nasal cannula > 2L/min or
Noninvasive positive airway pressure

Grade 3 BPD
Invasive mechanical ventilation

Obtain echocardiogram if any of the following are present:
- Discharge to home on any respiratory support between
  36-40 weeks PMA
or
Ongoing need for any degree of respiratory support at 40 weeks PMA

Obtain echocardiogram at 36 weeks

Review Echocardiogram for Evidence of PH

No Evidence for PH

Evidence for PH Present

Monthly screen while inpatient if remains on ≥ 2L/min.

Review results with local cardiologist and discuss if a formal consult to cardiology is needed to guide management including, timing of repeat echocardiogram.

Posted: November 2020
Reviewed: May 2023

Authors:
- C. Avitabile, MD;
- N. Bamat, MD;
- E. Eichenwald, MD;
- J. Fierro, MD;
- K. Gibbs, MD;
- E. Jensen, MD;
- K. Maschhoff, MD;
- H. Morris, PA-C;
- K. Nilan, RN;
- J. Patykula, CRNP;
- T. Pawlowski, MD;
- I. Peterside, MD;
- L. Sillers, MD;
- J. Stoller, MD

Editors: Clinical Pathways Team

References

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Inpatient and ICU Clinical Pathway for Pulmonary Hypertension (PH) Screenings in Patients with Bronchopulmonary Dysplasia (BPD)

References