Neonatal Intensive Care Unit, AOUP "P. Giaccone", Department of Sciences for Health Promotion and Mother and Child Care "G. D'Alessandro", University of Palermo, Via Alfonso Giordano n. 3, 90127, Palermo, Italy.
Ital J Pediatr. 2018 Aug 22;44(1):98. doi: 10.1186/s13052-018-0543-4.
Congenital space-occupying thoracic malformations and diaphragmatic hernia have in common pulmonary hypoplasia. Our study aims to assess cardiac involvement during post-natal adaptation.
A retrospective study was carried out on newborns with prenatally diagnosed intrathoracic mass. Gathering for respiratory distress syndrome (RDS), 35 neonates were compared for clinical course, cardiovascular enzymes, ECG, and ultrasound.
The analysis revealed a high left heart defect rate in patients with severe RDS, without being influenced by the laterality. Ultrasound or laboratory assessment did not detect altered cardiac dimension or cardiomyopathy. Solely ECG signs of right ventricular strain were found. Increased QT-dispersion, T-wave and cardiac variability alterations in the first hours were all expression of non-specific cardiac repolarization disorders but predict worse outcome.
Although RDS is the predominant symptom, slight cardiac dysfunctions should be recognized for prompt treatment. Conventional examinations for postnatal adaption should be integrated by complementary investigations.
先天性胸腔占位性畸形和横膈疝共同的特点是肺发育不良。我们的研究旨在评估出生后适应过程中心脏的受累情况。
对产前诊断为胸腔内肿块的新生儿进行回顾性研究。为了研究呼吸窘迫综合征（RDS），对 35 名新生儿的临床病程、心血管酶、心电图和超声进行了比较。
分析表明，严重 RDS 患者的左心缺陷发生率较高，但不受病变侧的影响。超声或实验室评估未发现心脏尺寸或心肌病的改变。仅发现心电图显示右心室应变的迹象。QT 离散度增加、T 波和心脏变异度改变在最初几个小时内均为非特异性心脏复极障碍的表现，但预测预后更差。
尽管 RDS 是主要的症状，但应识别轻微的心脏功能障碍，以便及时治疗。常规的出生后适应检查应结合补充检查。
