El Louali Fedoua, Prom Camille, Myriem Belghiti Alaoui, Gran Celia, Fouilloux Virginie, Lenoir Marien, Ligi Isabelle, Ovaert Caroline, Michel Fabrice
Department of Paediatric and Congenital Cardiology, Timone Hospital, Aix-Marseille University, Marseille, France
Department of Paediatric Anaesthesia and Intensive Care, Timone Children Hospital, Aix-Marseille University, Marseille, France.
BMJ Paediatr Open. 2024 Sep 15;8(1):e002520. doi: 10.1136/bmjpo-2024-002520.
The main risk factors of necrotising enterocolitis (NEC) are prematurity and low birth weight. The aim of our study was to identify risk factors for NEC in patients with duct-dependent congenital heart disease (CHD).
Newborns with duct-dependent CHD and NEC were matched 1:1 to those without NEC. Matched criteria were gestational age, birth weight, antenatal versus postnatal diagnosis and type of CHD.
Twenty-three infants were included in each group. In the NEC group, mortality, length of intensive care unit stay and length of hospital stay were significantly higher (p=0.035; p<0.0001; p<0.0001). Lower diastolic blood pressure (DBP), negative flow balance, peritoneal dialysis and epinephrine-infusion were significantly associated with NEC (respectively, p=0.008, p=0.002, p=0.007, p=0.017). In multivariate analysis, DBP≤30 mm Hg remained the only independent risk factor of NEC (OR=8.70; 95% CI (1.46 to 53.50), p=0.019).
A DBP lower than 30 mm Hg was in our matched population of newborns with duct-dependent CHD, independently associated with NEC.
坏死性小肠结肠炎（NEC）的主要危险因素是早产和低出生体重。我们研究的目的是确定导管依赖性先天性心脏病（CHD）患者发生NEC的危险因素。
将患有导管依赖性CHD且发生NEC的新生儿与未发生NEC的新生儿按1:1进行匹配。匹配标准为胎龄、出生体重、产前与产后诊断以及CHD类型。
每组纳入23例婴儿。在NEC组中，死亡率、重症监护病房住院时间和住院总时间显著更长（p = 0.035；p < 0.0001；p < 0.0001）。舒张压（DBP）较低、液体负平衡、腹膜透析和肾上腺素输注与NEC显著相关（分别为p = 0.008、p = 0.002、p = 0.007、p = 0.017）。多因素分析中，DBP≤30 mmHg仍然是NEC的唯一独立危险因素（OR = 8.70；95%CI（1.46至53.50），p = 0.019）。
在我们匹配的患有导管依赖性CHD的新生儿人群中，DBP低于30 mmHg与NEC独立相关。
