For Referring Physicians

Bronchopulmonary dysplasia (BPD) is a chronic lung disease that affects infants born prematurely. Pulmonary hypertension (PH) is a complication of prematurity and BPD and it contributes to significant morbidity and early mortality. Early diagnosis and treatment of PH is important, as many patients respond well to therapies. For many patients, PH can resolve by the time they reach early childhood.

We treat infants or children with a history of prematurity and BPD who are at risk for or have a known diagnosis of PH. We also follow patients with congenital heart disease and BPD.

Inpatient referrals

To request assistance with a patient transfer or to speak directly to a physician regarding the patient you are referring, please call (650) 723-7342 or visit our Transfer Center.

Outpatient referrals

Please call (800) 995-5724 and mention that you want to refer to the CRIB clinic, or use MD Portal and indicate CRIB.

The appointment schedule, services and testing will vary depending on the needs of the patient. At a minimum, the CRIB Program will include regular screening visits for all premature infants with BPD at around 6 months, 1 year, 2 years and 5 years of age. In addition to a combined visit with a cardiologist and pulmonologist, available services include respiratory therapy, nutrition and social work. The physician team will determine which imaging studies and laboratory tests are required.

The importance of specialized care for BPD and PH patients

Identifying BPD requires careful longitudinal evaluation and regular screening. Studies suggest 15 to 40 percent of infants with BPD develop PH. While PH is associated with BPD severity, many infants with severe BPD never develop PH and some infants with mild lung disease do. Additional risk factors include extremely low gestational age, low birth weight for gestational age, oligohydramnios, duration of mechanical ventilation and prolonged oxygen therapy. One recent study by Ramachandra Bhat and colleagues in the March 2012 issue of Pediatrics showed that PH affects 1 in 6 infants born weighing < 1,000 g.

Because of the complex cardiopulmonary interactions in infants with BPD, our multidisciplinary team collaborates to optimize respiratory support for these patients, diagnose and treat PH, and track patients’ growth and development with regular inpatient and outpatient assessments. We work together with families to ensure a seamless transition from inpatient to outpatient settings.