Episodes of apnea and periodic breathing in premature infants with BPD-associated pulmonary hypertension

Premature infants with bronchopulmonary dysplasia-associated pulmonary hypertension have a longer persistence of apnea of prematurity and periodic breathing. We hypothesized that apnea of prematurity and periodic breathing may be associated with the persistence of pulmonary hypertension in infants with bronchopulmonary dysplasia.

The aim of the study was to determine the characteristics of apnea episodes and periodic breathing in premature infants with bronchopulmonary dysplasia-associated pulmonary hypertension.

Characteristics of  children and research methods. Cardiorespiratory monitoring was conducted on 27 premature infants born at 22 0/7 — 29 0/7 weeks of gestation with a body weight of <1000 grams. All infants had bronchopulmonary dysplasia, and 14 infants with severe bronchopulmonary dysplasia were diagnosed pulmonary hypertension (main cohort).

Results. The group of infants with bronchopulmonary dysplasia + pulmonary hypertension had lower average SpO₂, higher desaturation index and apnea/hypopnea index as compared to infants without pulmonary hypertension. Four infants from the main cohort had obstructive apnea index of ˃1 events/hour and had high values of 1,1; 2,5; 5,8, and 8,6/hour. In the comparison group, only one infant had a high obstructive apnea index (1,1/hour). Eleven infants(78%) with pulmonary hypertension had episodes of periodic breathing, at the same time only six infants (46%) in the group without pulmonary hypertension had such episodes. Periodic breathing episodes with a drop of SpO₂ <90% were registered in 82% of cases in the main cohort and in 67% of cases in infants of the comparison group.

Conclusion. Premature infants with bronchopulmonary dysplasia and pulmonary hypertension had more significant decrease in mean SpO₂, increased desaturation index and apnea/hypopnea index and tend to have obstructive apnea index >1/hour and longer periodic breathing than infants without pulmonary hypertension.

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