Maneenil Gunlawadee, Janjindamai Waricha, Dissaneevate Supaporn, Thatrimontrichai Anucha
Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand.
Asian Biomed (Res Rev News). 2023 Aug 1;16(6):310-315. doi: 10.2478/abm-2022-0034. eCollection 2022 Dec.
Transient tachypnea of the newborn (TTN) is the consequence of delayed resorption of lung fluid. When TTN develops, the infant may develop severe hypoxemia and progress to persistent pulmonary hypertension of the newborn (PPHN).
To examine factors associated with the development of PPHN in TTN infants.
This retrospective study comprised 23 infants in whom a diagnosis of TTN with PPHN (TTN-PPHN) was confirmed and 59 infants with severe TTN without PPHN who required mechanical ventilation between 2009 and 2018 at Songklanagarind Hospital, Thailand. Logistic regression was used to assess factors associated with TTN and PPHN.
The factors identified by univariate analysis that were associated with development of PPHN were oxygen saturation (SpO) <90% and respiratory rate (RR) ≥70 breaths/min at the time of admission, mean airway pressure (MAP) ≥8 cmHO, oxygen index (OI) ≥10, partial pressure of oxygen (PaO) ≤60, partial pressure of carbon dioxide (PCO) ≥45 mmHg, and infants who did not receive positive pressure ventilation (PPV). In multivariate analyses, RR ≥70 breaths/min (adjusted odds ratio [aOR] 9.96, 95% confidence interval [CI] 2.1-47.29, < 0.001) and OI ≥10 (aOR 29.22, 95% CI 4.46-191.23, < 0.001) remained statistically significantly associated with PPHN.
High RR and high OI were factors associated with PPHN in TTN infants.
新生儿短暂性呼吸急促（TTN）是肺液吸收延迟的结果。当发生TTN时，婴儿可能会出现严重低氧血症，并进展为新生儿持续性肺动脉高压（PPHN）。
研究与TTN婴儿发生PPHN相关的因素。
这项回顾性研究纳入了2009年至2018年期间在泰国宋卡王子大学医学院附属医院确诊为TTN合并PPHN（TTN-PPHN）的23例婴儿，以及59例需要机械通气的重度TTN但无PPHN的婴儿。采用逻辑回归分析评估与TTN和PPHN相关的因素。
单因素分析确定的与PPHN发生相关的因素包括入院时氧饱和度（SpO）<90%、呼吸频率（RR）≥70次/分钟、平均气道压（MAP）≥8 cmH₂O、氧合指数（OI）≥10、氧分压（PaO）≤60、二氧化碳分压（PCO₂）≥45 mmHg，以及未接受正压通气（PPV）的婴儿。多因素分析中，RR≥70次/分钟（调整优势比[aOR] 9.96，95%置信区间[CI] 2.1-47.29，P<0.001）和OI≥10（aOR 29.22，95%CI 4.46-191.23，P<0.001）与PPHN仍具有统计学显著相关性。
高RR和高OI是TTN婴儿发生PPHN的相关因素。
