Wang Liling, Zhang Fengjuan, Li Jiahui, Liu Zhijie, Kou Yan, Song Yanting, Xu Haiyan, Wang Haiyan, Wang Yulin
Department of Pediatric Cardiology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
Department of Pediatrics, The First Affiliated Hospital of Shandong First Medical University, Jinan, China.
Transl Pediatr. 2021 Sep;10(9):2287-2297. doi: 10.21037/tp-21-341.
Pulmonary artery acceleration time (PAAT) is a reliable and non-invasive method for assessing pulmonary hemodynamics. To date, few studies have used PAAT to assess preterm infants, especially those with respiratory distress syndrome (RDS). This study aimed to assess changes in PAAT among preterm infants with RDS undergoing pulmonary surfactant (PS) therapy or not, and determine its potential effects on the pulmonary vascular disease (PVD) outcomes of preterm infants with RDS in the late postnatal period.
The risk of RDS was reviewed in 62 preterm infants with a gestational age of 26-31 weeks. The infants receiving PS therapy were allocated to the PS group, and the others were allocated to the control group. PAAT, right ventricular ejection time (RVET), and other ultrasonic parameters at 3 different time points after birth were studied and compared.
Infants in the PS group had a significantly lower PAAT (52.7±5.9 59.6±8.7; P=0.001) and PAAT/RVET (0.30±0.03 0.33±0.03; P=0.001) than those in the control group at 36 weeks postmenstrual age (PMA). No significant increases in PAAT/RVET were detected at 3 different times for the PS group (P=0.117), but both PAAT and PAAT/RVET increased significantly with time after birth in the control group (P<0.001).
Preterm infants with RDS might still have PVD in the late postnatal period and thus require long-term follow-up observation. PAAT appears to be a reliable non-invasive screening measure for evaluating pulmonary hemodynamics in preterm infants with RDS and late PVD.
肺动脉加速时间（PAAT）是评估肺血流动力学的一种可靠且无创的方法。迄今为止，很少有研究使用PAAT来评估早产儿，尤其是患有呼吸窘迫综合征（RDS）的早产儿。本研究旨在评估接受或未接受肺表面活性物质（PS）治疗的RDS早产儿的PAAT变化，并确定其对出生后期RDS早产儿肺血管疾病（PVD）结局的潜在影响。
回顾了62例孕周为26 - 31周的早产儿发生RDS的风险。接受PS治疗的婴儿被分配到PS组，其他婴儿被分配到对照组。研究并比较了出生后3个不同时间点的PAAT、右心室射血时间（RVET）及其他超声参数。
在月经龄（PMA）36周时，PS组婴儿的PAAT（52.7±5.9对59.6±8.7；P = 0.001）和PAAT/RVET（0.30±0.03对0.33±0.03；P = 0.001）显著低于对照组。PS组在3个不同时间点PAAT/RVET均未检测到显著增加（P = 0.117），但对照组中PAAT和PAAT/RVET均随出生后时间显著增加（P < 0.001）。
患有RDS的早产儿在出生后期可能仍有PVD，因此需要长期随访观察。PAAT似乎是评估患有RDS和晚期PVD的早产儿肺血流动力学的一种可靠的无创筛查指标。
