马来西亚新生儿持续性肺动脉高压婴儿的存活率及其相关死亡风险因素。

Survival and associated risk factors for mortality among infants with persistent pulmonary hypertension of the newborn in Malaysia.

机构信息

Department of Pediatrics, Hospital Sultanah Aminah, Ministry of Health, Johor Bahru, Malaysia.

出版信息

J Perinatol. 2021 Apr;41(4):786-793. doi: 10.1038/s41372-021-00962-6. Epub 2021 Feb 15.

DOI:10.1038/s41372-021-00962-6

PMID:33589728

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7883964/

Abstract

OBJECTIVE

This study aims to determine the immediate outcome of persistent pulmonary hypertension of the newborn (PPHN) and risk factors for mortality in the era of inhaled nitric oxide (iNO).

STUDY DESIGN

This observational cross-sectional study includes 195 confirmed PPHN with a gestational age of ≥34 weeks without congenital heart disease. Multivariable logistic regression was used to identify risk factors for mortality.

RESULTS

The mortality rate was 16.4%, with the highest mortality with pulmonary hypoplasia. Of 195, 65% received iNO; 18% were iNO non-responders with the majority having pulmonary hypoplasia. Independent risk factors for mortality were the presence of reversal of flow at the descending aorta, pulmonary hypoplasia, APGAR scores ≤ 5 at 5 min, and idiopathic PPHN with an adjusted odds ratio of 15.9, 7.5, 6.7, and 6.4, respectively.

CONCLUSIONS

Despite the usage of iNO, mortality due to PPHN remains high and is related to etiology and cardiac function.

摘要

目的

本研究旨在确定吸入一氧化氮（iNO）时代新生儿持续性肺动脉高压（PPHN）的即刻结局和死亡的危险因素。

研究设计

本观察性横断面研究纳入了 195 例胎龄≥34 周且无先天性心脏病的确诊 PPHN 患儿。采用多变量逻辑回归分析确定死亡的危险因素。

结果

死亡率为 16.4%，肺发育不良的死亡率最高。195 例患儿中，65%接受了 iNO 治疗；18%为 iNO 无反应者，其中大多数存在肺发育不良。死亡的独立危险因素为降主动脉出现反流、肺发育不良、5 分钟时 APGAR 评分≤5 分以及特发性 PPHN，校正后比值比分别为 15.9、7.5、6.7 和 6.4。