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前列腺素E1累积剂量决定等待心脏手术的足月儿和近足月儿的胃肠道不良反应：一项回顾性队列研究

Cumulative Dose of Prostaglandin E1 Determines Gastrointestinal Adverse Effects in Term and Near-Term Neonates Awaiting Cardiac Surgery: A Retrospective Cohort Study.

作者信息

Ofek Shlomai Noa, Lazarovitz Gilad, Koplewitz Benjamin, Eventov Friedman Smadar

机构信息

Department of Neonatology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel.

Department of Radiology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel.

出版信息

Children (Basel). 2023 Sep 19;10(9):1572. doi: 10.3390/children10091572.

DOI:10.3390/children10091572
PMID:37761532
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10528554/
Abstract

OBJECTIVE

This study aimed to assess the association between treatment characteristics of prostaglandin E1 including initiation time and duration, maximal and cumulative doses, and adverse effects.

DESIGN

A retrospective cohort study in which medical records of neonates with duct-dependent lesions were studied for treatment parameters and adverse effects. Multivariable logistic regression model was applied for testing the effect PGE1 variables on outcomes.

MAIN OUTCOME MEASURES

The primary outcomes of this study were association of adverse effects of PGE1 treatment with maximal dose, cumulative dose, and treatment duration. The secondary outcomes included safety of feeding in infants treated with PGE1.

RESULTS

Eighty-two infants with duct-dependent lesions receiving PGE1 were included. Several infants who received early PGE1 treatment required ventilation support. Feeds were ceased more often as the cumulative dose and duration of PGE1 treatment increased. Gastrointestinal adverse effects were significantly associated with the cumulative dose of PGE1 and treatment duration. Apneas, hyperthermia, and tachycardia were associated with maximal dose. Our data did not demonstrate a difference in the incidence of NEC associated with characteristics of PGE1 treatment.

CONCLUSION

Cumulative PGE1 dose is associated with gastrointestinal adverse effects in neonates. Lower doses should be considered in neonates expecting prolonged PGE1 treatment.

摘要

目的

本研究旨在评估前列腺素E1的治疗特征（包括起始时间、持续时间、最大剂量和累积剂量）与不良反应之间的关联。

设计

一项回顾性队列研究，研究依赖导管病变新生儿的病历以获取治疗参数和不良反应。应用多变量逻辑回归模型来测试前列腺素E1变量对结果的影响。

主要观察指标

本研究的主要结局是前列腺素E1治疗的不良反应与最大剂量、累积剂量和治疗持续时间之间的关联。次要结局包括接受前列腺素E1治疗的婴儿的喂养安全性。

结果

纳入了82例接受前列腺素E1治疗的依赖导管病变的婴儿。几名接受早期前列腺素E1治疗的婴儿需要通气支持。随着前列腺素E1治疗的累积剂量和持续时间增加，喂养中断的情况更频繁。胃肠道不良反应与前列腺素E1的累积剂量和治疗持续时间显著相关。呼吸暂停、体温过高和心动过速与最大剂量相关。我们的数据未显示与前列腺素E1治疗特征相关的坏死性小肠结肠炎发生率存在差异。

结论

前列腺素E1的累积剂量与新生儿的胃肠道不良反应相关。对于预期需要长期接受前列腺素E1治疗的新生儿，应考虑使用较低剂量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d30e/10528554/e7d8fe523f5b/children-10-01572-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d30e/10528554/3df27d9cfffa/children-10-01572-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d30e/10528554/e5f443f2010f/children-10-01572-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d30e/10528554/e7d8fe523f5b/children-10-01572-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d30e/10528554/3df27d9cfffa/children-10-01572-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d30e/10528554/e5f443f2010f/children-10-01572-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d30e/10528554/e7d8fe523f5b/children-10-01572-g003.jpg

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Pediatr Surg Int. 2023 Mar 1;39(1):144. doi: 10.1007/s00383-023-05428-8.
3
Outcome and factors associated with undernutrition among children with congenital heart disease.
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PLoS One. 2023 Feb 23;18(2):e0281753. doi: 10.1371/journal.pone.0281753. eCollection 2023.
4
Standardizing Prostaglandin Initiation in Prenatally Diagnosed Ductal-Dependent Neonates; A Quality Initiative.规范产前诊断出的依赖导管供血新生儿的前列腺素应用；一项质量改进计划。
Pediatr Cardiol. 2023 Aug;44(6):1327-1332. doi: 10.1007/s00246-022-03075-9. Epub 2022 Dec 20.
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Development of necrotizing enterocolitis in full-term infants with duct dependent congenital heart disease.足月患依赖导管型先天性心脏病婴儿发生坏死性小肠结肠炎。
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