Episodes of Periodic Breathing in Premature Infants with BPD-associated Pulmonary Hypertension

Premature infants with BPD-associated pulmonary hypertension (PH) are characterized by saturation fluctuations. This contributes to the emergence of intermittent hypoxic episodes, which can exacerbate episodes of periodic breathing (PB). The aim of the study was to determine the characteristics of periodic breathing in premature infants with BPD-associated PH. Materials and methods. Cardiorespiratory monitoring was performed for 27 premature infants born on 22 0/7 - 29 0/7 weeks of gestation with a body weight of ˂1000 grams, before discharge from the hospital at 35-44 weeks of postmenstrual age. All infants had BPD, 14 infants with severe BPD were diagnosed with PH (BPD+PH group). Results. The group of BPD+PH was characterized by lower mean SpO2 (93,1 (89,0-96,6)%) (p=0.02), higher apnea/hypopnea index (15,7(1,7-95,2) events/hour) (p=0.03) and desaturation (37,2 (13,3-133,5) events/hour) (p=0.02) index than infants without PH (98,0 (92,3-98,7)%, 4 (0,3-38,6) events/hour and 24,6 (0,8-61,8) events/hour, respectively). Infants with BPD and PH had more desaturation episodes within 5-9% and desaturation <90% per hour. Percentage of time spent with saturation <90% was greater in infants with BPD and PH (p=0.006). In the BPD+PH group, 11 infants (78%) had episodes of PB, in the group without PH, only 6 infants (46%) had these episodes (p=0.08). Episodes of PB were accompanied by drops of SpO2 below 90% in 82% of cases in the BPD+PH group and in 67% of cases in compared infants. All episodes of PB were characterized by subsequent self-repair SpO2 and did not require additional therapeutic measures. We did not obtain differences in apnea/hypopnea index and the average and maximum duration of these episodes. Conclusions. Premature infants with BPD and PH are characterized by a lower average SpO2, higher apnea/hypopnea and desaturation indices, a tendency to more common PB than infants with BPD and without PH.