长期气管插管对动脉导管未闭与支气管肺发育不良（2 级和 3 级）之间关联的影响。
The effect of prolonged tracheal intubation on the association between patent ductus arteriosus and bronchopulmonary dysplasia (grades 2 and 3).
机构信息
Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA.
Department of Cardiovascular Research Institute, University of California San Francisco, San Francisco, CA, USA.
出版信息
J Perinatol. 2020 Sep;40(9):1358-1365. doi: 10.1038/s41372-020-0718-x. Epub 2020 Jul 15.
OBJECTIVE
To determine if the need for mechanical ventilation alters the association between prolonged patent ductus arteriosus (PDA) exposure and bronchopulmonary dysplasia (grades 2 and 3) (BPD).
STUDY DESIGN
Observational study of 407 infants (<28 weeks' gestation) with echocardiograms performed at planned intervals.
RESULTS
Twelve percent (48/407) of study infants had BPD (grades 2 and 3). In a multivariable regression model, exposure to a moderate-to-large PDA shunt for ≥7 days was associated with an increased risk of BPD (grades 2 and 3) (from 16 to 35%: aRD = 19% (6, 32%), p < 0.005) when infants required ≥10 days of intubation (n = 170). In contrast, there was no significant association between prolonged PDA exposure and BPD when infants required ≤9 days of intubation (aRD = 4%) (-1, 10%) (n = 237).
CONCLUSIONS
Moderate-to-large PDAs are associated with an increased risk of BPD-but only when infants require intubation ≥10 days.
目的
确定机械通气的需求是否改变了持续性动脉导管未闭（PDA）暴露与支气管肺发育不良（2 级和 3 级）（BPD）之间的关联。
研究设计
对 407 名接受计划间隔进行超声心动图检查的<28 周龄婴儿进行观察性研究。
结果
研究中有 12%（48/407）的婴儿患有 BPD（2 级和 3 级）。在多变量回归模型中，当婴儿需要≥10 天的插管时，暴露于中至大量 PDA 分流≥7 天与 BPD（2 级和 3 级）的风险增加相关（从 16%增加到 35%：aRD=19%（6，32%），p<0.005）（n=170）。相比之下，当婴儿需要≤9 天的插管时（n=237），长时间 PDA 暴露与 BPD 之间没有显著关联（aRD=4%（-1，10%））。
结论
中至大量 PDA 与 BPD 的风险增加相关-但仅在婴儿需要插管≥10 天时才会如此。
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