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利用新的超声心动图参数预测新生儿持续性肺动脉高压的严重程度和预后

Predicting the Severity and Outcome of Persistent Pulmonary Hypertension of the Newborn Using New Echocardiography Parameters.

作者信息

Butt Muhammad Umer, Jabri Ahmad, Hamade Hani, Abdouh Ahmad Al, Mhanna Mohammed, Haddadin Faris, Nasser Farhan, Hammad Nour, Jazar Deaa Abu, Toumar Ahmad J, Siraj Aisha, Balakumaran Kathir, Ilbawi Michel

机构信息

Heart and Vascular Center, Metrohealth Medical Center, Cleveland, OH.

Heart and Vascular Center, Metrohealth Medical Center, Cleveland, OH.

出版信息

Curr Probl Cardiol. 2023 Aug;48(8):101181. doi: 10.1016/j.cpcardiol.2022.101181. Epub 2022 Mar 24.

Abstract

To examine echocardiographic parameters correlation with clinical severity indices, Alveolar- arterial gradient (A-a gradient), oxygenation index and clinical outcomes in newborns with persistent pulmonary hypertension of the newborn (PPHN). Retrospective cohort study of 67 subjects, >35 weeks' gestation with the diagnosis of PPHN admitted to the University of Kentucky neonatal intensive care unit (NICU) between September 2014 and December 2016. High left ventricular end-systolic eccentricity index (EIs) correlates with the overall clinical severity of PPHN as it is associated with higher A-a gradient and oxygenation index (P = 0.0003 and P < 0.0001, respectively). Elevated EIs was also predictive for the use of inhaled nitric oxide and extracorporeal membrane oxygenation (P = 0.0004 and P < 0.0001, respectively). EIs value of >1.38 provides cutoff value as an objective marker for the need for extracorporeal membrane oxygenation. EIs can be used to assess clinical severity and outcomes and should be reported routinely. Further studies are warranted to confirm these results.

摘要

为研究超声心动图参数与临床严重程度指标、新生儿持续性肺动脉高压(PPHN)患儿的肺泡-动脉血氧分压差(A-a梯度)、氧合指数及临床结局之间的相关性。对2014年9月至2016年12月间入住肯塔基大学新生儿重症监护病房(NICU)、孕周>35周且诊断为PPHN的67例患儿进行回顾性队列研究。高左心室收缩末期偏心指数(EIs)与PPHN的总体临床严重程度相关,因为它与较高的A-a梯度和氧合指数相关(分别为P = 0.0003和P < 0.0001)。EIs升高还可预测吸入一氧化氮和体外膜肺氧合的使用情况(分别为P = 0.0004和P < 0.0001)。EIs值>1.38可作为体外膜肺氧合需求的客观标志物的临界值。EIs可用于评估临床严重程度和结局,应常规报告。需要进一步研究以证实这些结果。

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