Pulmonary Hypertension and Nissen Fundoplication in Premature Infants with Bronchopulmonary Dysplasia

Objective: The purpose of this study was to evaluate the association of the combined effects of pulmonary hypertension (PHTN) and Nissen fundoplication on clinical outcomes in premature infants with bronchopulmonary dysplasia (BPD). Study Design: Single-center retrospective cohort study of premature infants with severe BPD from 2016 to 2021. Patients were analyzed based on Nissen utilization and presence of PHTN. Multivariable regression modeling was used to compare groups based on the primary outcome of time to weaning from significant respiratory support. Results: Among 91 infants, those who underwent Nissen with a preoperative diagnosis of PHTN had the most delayed liberation from respiratory support relative to infants with neither Nissen nor PHTN (adjusted HR: 0.09, 95% confidence interval: 0.03-0.28). PHTN, regardless of Nissen status, was independently associated with delayed weaning from significant respiratory support. Conclusion: Following Nissen fundoplication, patients with BPD and PHTN experienced a longer time to weaning from significant respiratory support and greater healthcare resource utilization. Nissen alone did not improve respiratory recovery in premature infants with severe BPD. Key Points: · PHTN was independently associated with delayed respiratory recovery in severe BPD.. · Infants with PHTN undergoing Nissen had the slowest respiratory recovery.. · Nissen fundoplication was not associated with earlier respiratory recovery after adjustment..