持续性肺动脉高压和氧合对接受治疗性低温治疗的新生儿脑病新生儿脑损伤的影响。
Impact of persistent pulmonary hypertension and oxygenation on brain injury in neonates with neonatal encephalopathy treated with therapeutic hypothermia.
作者信息
Kilmartin Keira C, Al Balushi Asim, Altit Gabriel, Lapointe Anie, Rampakakis Emmanouil, Barbosa Vargas Stephanie, Maluorni Julie, Wintermark Pia
机构信息
Division of Newborn Medicine, Department of Pediatrics, Montreal Children's Hospital, McGill University, Montreal, QC, Canada.
Department of Pediatric Cardiology, National Heart Centre, Muscat, Oman.
出版信息
J Perinatol. 2024 Apr;44(4):513-520. doi: 10.1038/s41372-023-01805-2. Epub 2023 Oct 23.
OBJECTIVE
To investigate the effects of persistent pulmonary hypertension (PPHN) and oxygenation on outcome of neonates with neonatal encephalopathy (NE) treated with therapeutic hypothermia (TH).
STUDY DESIGN
We compared the outcome of neonates with NE treated with TH with or without PPHN.
RESULTS
384 neonates with NE were treated with TH; 24% had PPHN. The fraction of inspired oxygen was higher in the first 4 days of life (p < 0.001) in neonates with PPHN. They had a significantly lower arterial partial pressure of oxygen in the first 4 days of life (p = 0.005) and higher on days 3-4 of life (p < 0.001). They were more often intubated (p < 0.001) and more often had concomitant hypotension (p < 0.001). They had higher mortality (p = 0.009) and more often developed brain injury (p = 0.02).
CONCLUSION
PPHN occurred frequently in neonates with NE treated with TH and was associated with a higher incidence of adverse outcome.
目的
探讨持续性肺动脉高压（PPHN）和氧合对接受亚低温治疗（TH）的新生儿脑病（NE）患儿预后的影响。
研究设计
我们比较了接受TH治疗的合并或不合并PPHN的NE新生儿的预后情况。
结果
384例NE新生儿接受了TH治疗；其中24%患有PPHN。PPHN新生儿在出生后前4天的吸入氧分数更高（p < 0.001）。他们在出生后前4天的动脉血氧分压显著更低（p = 0.005），而在出生后第3 - 4天则更高（p < 0.001）。他们更常需要插管（p < 0.001），且更常伴有低血压（p < 0.001）。他们的死亡率更高（p = 0.009），且更常发生脑损伤（p = 0.02）。
结论
接受TH治疗的NE新生儿中PPHN发生率较高，且与不良预后的发生率较高相关。
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