Kovacs Kata, Giesinger Regan E, Lakatos Andrea, Szabo Attila J, Szabo Miklos, Jermendy Agnes, McNamara Patrick J
Division of Neonatology 1st Department of Paediatrics, Semmelweis University, Budapest, Hungary.
Department of Pediatrics, University of Iowa, Iowa city, IA, USA.
J Perinatol. 2022 Dec;42(12):1637-1643. doi: 10.1038/s41372-022-01459-6. Epub 2022 Jul 20.
To analyze the association between cardiovascular care and adverse outcome in infants undergoing therapeutic hypothermia for neonatal encephalopathy (NE).
This was a retrospective cohort study of 176 infants with NE and hypotension, admitted to the SickKids Hospital (Center A, n = 86) or Semmelweis University (Center B, n = 90).
The lowest systolic/diastolic blood pressures were comparable amongst centers; however, proportion of cardiovascular support was lower in Center A (51% vs 97% in Center B). Overall rate of death or abnormal MRI (adverse outcome) were comparable between centers, although pattern differed with more basal ganglia injury in Center B. A 24-hour longer duration of cardiovascular support increased the odds for adverse outcome by 14%.
We demonstrated that management of hemodynamic instability in infants with NE was markedly different in two high-volume NICUs and showed that longer duration of cardiovascular medication is an independent risk factor for adverse outcome.
分析新生儿脑病（NE）亚低温治疗婴儿的心血管护理与不良结局之间的关联。
这是一项对176例患有NE和低血压的婴儿进行的回顾性队列研究，这些婴儿被收治于病童医院（A中心，n = 86）或塞梅尔维斯大学（B中心，n = 90）。
各中心最低收缩压/舒张压相当；然而，A中心心血管支持的比例较低（51%，而B中心为97%）。各中心之间死亡或MRI异常（不良结局）的总体发生率相当，尽管模式有所不同，B中心基底神经节损伤更多。心血管支持持续时间延长24小时会使不良结局的几率增加14%。
我们证明，两个大型新生儿重症监护病房对NE婴儿血流动力学不稳定的管理存在显著差异，并表明心血管药物使用时间延长是不良结局的独立危险因素。
