美国儿童医院中极早产儿使用肺血管扩张剂的情况。
Pulmonary vasodilator use in very preterm infants in United States children's hospitals.
作者信息
Bamat Nicolas, Vega Tomas, Huber Matthew, Jensen Erik, Avitabile Catherine, Lorch Scott, Gibbs Kathleen, O'Byrne Michael, Frank David, Bamat Nicolas
机构信息
The Children's Hospital of Philadelphia.
The Children's Hospital of Philadelphia and the University of Pennsylvania.
出版信息
Res Sq. 2024 Dec 5:rs.3.rs-5492163. doi: 10.21203/rs.3.rs-5492163/v1.
OBJECTIVES
To describe common pulmonary vasodilators (PV), exposure timing, and characteristics associated to their use in very preterm (VP) infants.
STUDY DESIGN
Observational study of VP infants discharged from U.S. children's hospitals (2011-2021). PV exposures during hospitalization were identified, and multivariable modeling determined characteristics associated with exposure.
RESULTS
Among 37,428 infants, 6.3% received PV. Early inhaled nitric oxide (iNO) and late sildenafil were most common. Early exposure was associated with lower gestational age, aOR: 9.2 (7.3-11.7), 22-25 vs. 29-31 weeks) and small for gestational age (SGA), 2.3 (2.0-2.7). Late exposure was associated with bronchopulmonary dysplasia (BPD) grade, 26.2 (16.8-40.9), grade 3 vs. no BPD) and early PV exposure, 3.7 (2.9-4.8).
CONCLUSIONS
Early iNO and late sildenafil are used in VP infants despite limited evidence. Prospective early studies enrolling extremely preterm or SGA infants and late studies enrolling infants with early PV exposure or high-grade BPD would target current evidence gaps.
目的
描述常见的肺血管扩张剂（PV）、暴露时间及其在极早产儿（VP）中的使用特征。
研究设计
对美国儿童医院出院的VP婴儿进行观察性研究（2011 - 2021年）。确定住院期间的PV暴露情况，并通过多变量建模确定与暴露相关的特征。
结果
在37428名婴儿中，6.3%接受了PV治疗。早期吸入一氧化氮（iNO）和晚期西地那非最为常见。早期暴露与较低的胎龄相关，比值比（aOR）为9.2（7.3 - 11.7），胎龄22 - 25周与29 - 31周相比）以及小于胎龄儿（SGA）相关，aOR为2.3（2.0 - 2.7）。晚期暴露与支气管肺发育不良（BPD）分级相关，aOR为26.2（16.8 - 40.9），3级BPD与无BPD相比）以及早期PV暴露相关，aOR为3.7（2.9 - 4.8）。
结论
尽管证据有限，VP婴儿仍使用早期iNO和晚期西地那非。纳入极早产儿或SGA婴儿的前瞻性早期研究以及纳入有早期PV暴露或重度BPD婴儿的晚期研究将针对当前的证据空白。
Zotero 插件