Fernandez Erika, Watterberg Kristi L, Faix Roger G, Yoder Bradley A, Walsh Michele C, Lacy Conra Backstrom, Osborne Karen A, Das Abhik, Kendrick Douglas E, Stoll Barbara J, Poindexter Brenda B, Laptook Abbot R, Kennedy Kathleen A, Schibler Kurt, Bell Edward F, Van Meurs Krisa P, Frantz Ivan D, Goldberg Ronald N, Shankaran Seetha, Carlo Waldemar A, Ehrenkranz Richard A, Sánchez Pablo J, Higgins Rosemary D
Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, New Mexico.
Division of Neonatology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah.
Am J Perinatol. 2015 Sep;32(11):1024-30. doi: 10.1055/s-0035-1547321. Epub 2015 Mar 31.
We previously reported on the overall incidence, management, and outcomes in infants with cardiovascular insufficiency (CVI). However, there are limited data on the relationship of the specific different definitions of CVI to short-term outcomes in term and late preterm newborn infants.
This study aims to evaluate how four definitions of CVI relate to short-term outcomes and death.
The previously reported study was a multicenter, prospective cohort study of 647 infants ≥ 34 weeks gestation admitted to a Neonatal Research Network (NRN) newborn intensive care unit (NICU) and mechanically ventilated (MV) during their first 72 hours. The relationship of five short-term outcomes at discharge and four different definitions of CVI were further analyzed.
All the four definitions were associated with greater number of days on MV and days on O2. The definition using a threshold blood pressure (BP) measurement alone was not associated with days of full feeding, days in the NICU or death. The definition based on the treatment of CVI was associated with all the outcomes including death.
The definition using a threshold BP alone was not consistently associated with adverse short-term outcomes. Using only a threshold BP to determine therapy may not improve outcomes.
我们之前报道了心血管功能不全（CVI）婴儿的总体发病率、治疗及预后情况。然而，关于CVI的具体不同定义与足月儿和晚期早产儿短期预后之间关系的数据有限。
本研究旨在评估CVI的四种定义与短期预后及死亡之间的关系。
之前报道的研究是一项多中心前瞻性队列研究，纳入了647例孕周≥34周、入住新生儿研究网络（NRN）新生儿重症监护病房（NICU）且在出生后72小时内接受机械通气（MV）的婴儿。进一步分析了出院时的五项短期预后与CVI的四种不同定义之间的关系。
所有四种定义均与MV天数和吸氧天数增加相关。仅使用阈值血压（BP）测量的定义与完全喂养天数、NICU住院天数或死亡无关。基于CVI治疗的定义与包括死亡在内的所有预后相关。
仅使用阈值BP的定义与不良短期预后并非始终相关。仅使用阈值BP来确定治疗方案可能无法改善预后。
