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Pediatric pneumology

Bronchiolitis and pulmonary hypertension

Luiza Bardi-Peti
Bronchiolitis and pulmonary hypertension

The study was undertaken to assess whether previously healthy infants with bronchiolitis develop elevated pulmonary artery pressures. We performed 2D and Doppler echocardiography in 94 infants, aged between 2 and 12 months, from November 2007 to December 2009. 47 infants had bronchiolitis and 47 were in the control group. We excluded children with congenital heart diseases

and other conditions associated with pulmonary hypertension. The method of time to peak velocity corrected for heart rate was used to estimate pulmonary arterial pressure (PAP). A Student's t-test for independent samples was used to compare the mean values of variables. Increased mean pulmonary pressures (>25mmHg) were measured in 13 infants with bronchiolitis. The values were categorized as mild-moderate pulmonary hypertension. Mean PAP were significantly increased in subjects with bronchiolitis, vs. control (p=0.001). In infants with bronchiolitis, hospitalisation was significantly longer at patients with pulmonary hypertension vs. normal PAP (p= 0.006).

Mean PAP were significantly increased in subjects with a moderate/severe episode of wheezing at admission vs. a mild episode (p=0.001). Echocardiography brings valuable informations regarding pulmonary hypertension in bronchiolitis. PHT could be a criterion in establishing the severity of disease, a prognosis factor and an element of therapeutic guidance.

Key words: bronchiolitis, pulmonary hypertension, infants