动脉导管未闭血流与极早产儿家庭氧疗的关系。
Association between patent ductus arteriosus flow and home oxygen therapy in extremely preterm infants.
机构信息
Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.
Institute of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.
出版信息
Pediatr Res. 2024 Jul;96(1):208-215. doi: 10.1038/s41390-024-03120-8. Epub 2024 Mar 7.
BACKGROUND
Central blood flow measurements include the estimation of right and left ventricular output (RVO, LVO), superior vena cava (SVC) flow, and calculated patent ductus arteriosus (PDA) flow. We aimed to provide an overview of the maturation patterns of these values and the relationship between PDA flow and the need for home oxygen therapy.
METHODS
This prospective single-center study was conducted in infants born at <26 weeks of gestation. We performed echocardiographic measurements five times during their life (from the 4th post-natal day to the 36th postmenstrual week).
RESULTS
Sixty patients with a mean birth weight of 680 (590, 760) g were included. Postnatal development of LVO and PDA flow peaked at the end of the second postnatal week (427 and 66 mL/kg/min, respectively). The RVO increased between days 4 and 7-8. The SVCF was most stable. The development curves of PDA flow differed between the groups with (n = 28; 47%) and without home oxygen therapy.
CONCLUSION
We present the central blood flow values and their postnatal development in infants <26 weeks of gestation. This study demonstrates the association between PDA flow and the future need for home oxygen therapy.
IMPACT
This study enriches our knowledge of the long-term development of central blood flow parameters and derived patent ductus arteriosus (PDA) flow in extremely preterm infants (<26 weeks). While pulmonary resistance decreased, PDA flow continued to increase from day 4 to the end of the second week of life. Similarly, left ventricular output increased as a marker of preload. The superior vena cava flow remained stable. The observed association between PDA flow and an unfavorable respiratory outcome is important for future studies focusing on the prevention of chronic lung disease.
背景
中心血流测量包括右心室输出量(RVO)、左心室输出量(LVO)、上腔静脉(SVC)血流和计算出的动脉导管未闭(PDA)血流的估计。我们旨在概述这些值的成熟模式以及 PDA 流量与家庭氧疗需求之间的关系。
方法
这是一项在 <26 周龄出生的婴儿中进行的前瞻性单中心研究。我们在他们的生命中进行了五次超声心动图测量(从出生后的第 4 天到第 36 个孕周)。
结果
纳入 60 名平均出生体重为 680(590,760)g 的患者。LVO 和 PDA 流量的出生后发育在第二周末达到峰值(分别为 427 和 66mL/kg/min)。RVO 在第 4 天至第 7-8 天之间增加。SVCF 最为稳定。有(n=28;47%)和没有家庭氧疗需求的两组之间的 PDA 流量发育曲线不同。
结论
我们提出了 <26 周龄婴儿的中心血流值及其出生后的发育情况。本研究表明 PDA 流量与未来家庭氧疗需求之间存在关联。
影响
本研究丰富了我们对极早产儿(<26 周)中心血流参数及其衍生的动脉导管未闭(PDA)流量长期发育的认识。尽管肺阻力降低,但 PDA 流量从第 4 天到第二周末仍继续增加。同样,左心室输出量增加作为前负荷的标志物。观察到的 PDA 流量与不良呼吸结局之间的关联对于未来关注预防慢性肺部疾病的研究很重要。
相似文献
Arch Dis Child Fetal Neonatal Ed. 2005-9
Zhongguo Dang Dai Er Ke Za Zhi. 2022-1-15
本文引用的文献
N Engl J Med. 2023-3-16
Cochrane Database Syst Rev. 2020-12-10
Clin Perinatol. 2020-9
Front Bioeng Biotechnol. 2019-11-12
Am J Respir Crit Care Med. 2019-9-15
Congenit Heart Dis. 2019-1