Page 1 of 5 Bronchopulmonary Dysplasia Associated Pulmonary Hypertension – A Survey of Current Practices in USA and Canada Amna Qasim*, Aman Jain and Sunil K Jain University of Texas Medical Branch, USA Introduction The increased survival of premature infants has led to an increased incidence of complications associated with prematurity. Bronchopulmonary dysplasia (BPD) is the most common chronic lung disease associated with prematurity that affects approximately 10,000-15,000 preterm infants [1] in USA alone with health costs exceeding $2.4 billion in USA alone [2] Pulmonary hypertension (PH) is one of the most significant complications of BPD due to its high associated morbidity and mortality. PH complicates approximately one-third infants with BPD cases [3-5] with high mortality (40%) [6]. There are several risk factors associated with the development of BPD_PH and multiple studies have been done in the past few years to understand this common and significant complication of prematurity. However, due to the scarcity of large-scale studies, questions like when we should screen for BPD_PH, what the appropriate screening tools are and how to optimally manage once screening tests are positive remain unanswered. The American Heart Association (AHA) and American Thoracic Society (ATS) published the first set of guidelines for BPD-PH in 2015 (summarized in Table 1) [7]. Shortly after that, in 2017, the Pediatric Pulmonary hypertension network published their own guidelines [8]. The purpose of our study was to find out what the current practices are in the management of BPD-PH in USA and Canada in response to the AHA/ATS 2015 guidelines. Table 1: Summary of AHA/ATS Guidelines for BPD_PH (2015) [7]. 1. PH screening by echocardiogram is recommended in infants with established BPD (Class I; Level of Evidence B); Timing of screening: a) Depending on clinical condition of worsening respiratory distress or risk factors of extreme prematurity (gestational age < 26 weeks); b) Every infant at 36 weeks who is diagnosed with moderate or severe BPDi. 2. Evaluation and treatment of lung disease, including assessments for hypoxemia, aspiration, structural airway disease, and the need for changes in respiratory support, are recommended in infants with BPD_ PH before initiation of PAHii-targeted therapy (Class I; Level of Evidence B). *Corresponding author: Amna Qasim, Department of Pediatrics, University of Texas Medical Branch, USA. Received Date: February 10, 2019 Published Date: February 15, 2019 Global Journal of Pediatrics & Neonatal Care Open Access Research Article Copyright © All rights are reserved by Amna Qasim This work is licensed under Creative Commons Attribution 4.0 License GJPNC.MS.ID.000504. Abstract Objective: To evaluate the implementation of the American Heart Association (AHA) and American Thoracic Society (ATS) 2015 guidelines in the diagnosis (including the utility of cardiac catheterization) and management of bronchopulmonary dysplasia associated pulmonary hypertension (BPD-PH) in USA and Canada. Methods: A validated 25-item questionnaire was sent to academic neonatal centers in USA and Canada to collect information on diagnosis, screening protocols, availability of resources and management of BPD-PH. Results: 133 responses were included (112 USA and 21 Canadian providers). There were no significant differences in the resources and practices between USA and Canada. ECHO alone is most commonly used to screen infants for BPD-PH and cardiac catheterization is rarely utilized. Treatment of BPD-PH includes use of oxygen to maintain saturations > 95%, Sildenafil, Nitric oxide and combination of all above. Conclusion: The AHA/ATS guidelines are being implemented partly. There is an urgent need for appropriate and practical guidelines for the management of BPD-PH.