Zhang Wei, Tan Yu-Yu, Zou You-Qun, Wen Shu-Sheng, Yang Min, Liu Yu-Mei
Department of Neonatology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 510080 Guangzhou, Guangdong, China.
Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 510080 Guangzhou, Guangdong, China.
Rev Cardiovasc Med. 2025 Aug 27;26(8):39250. doi: 10.31083/RCM39250. eCollection 2025 Aug.
This study aimed to determine the optimal dosages of prostaglandin E1 required to maintain a patent ductus arteriosus (PDA) in infants with transposition of the great arteries (TGA) based on point-of-care ultrasound (POCUS) findings.
Infants with TGA were recruited from two groups (the historical control group and the POCUS group that received POCUS in combination with pulse oximetry saturation (SpO) to titrate the dose of prostaglandin E1 (PGE1)).
A total of 150 patients were included in this study. The mean gestational ages were 38.6 weeks and 38.9 weeks, respectively, and the mean birth weights were 3.09 kg and 3.23 kg, respectively, in the control and POCUS groups. The rate of PGE1 prescriptions in the control group (93.3%) was higher than in the POCUS group (71.1%; < 0.001). The time at which PGE1 was initiated (prenatally diagnosed) was earlier than in the control group (0.05 ± 0.01 vs. 1.66 ± 3.72 d; < 0.001). The proportion of patients using a low dose (less than 5 ng/kg⋅min) of PGE1 was higher in the POCUS group (40.6% vs. 8.9%; < 0.001). The multivariate logistic regression analysis indicated that implementing POCUS significantly reduces the dosage of PGE1.
POCUS can optimize the use of PGE1, reduce unnecessary usage, postpone the initiation of PGE1, minimize the maintenance dose, and reduce the impact dose. POCUS guidance enhances the safety and effectiveness of PGE1 in infants with TGA.
本研究旨在根据床旁超声（POCUS）检查结果，确定维持大动脉转位（TGA）婴儿动脉导管未闭（PDA）所需的前列腺素E1最佳剂量。
从两组中招募TGA婴儿（历史对照组和接受POCUS联合脉搏血氧饱和度（SpO）以滴定前列腺素E1（PGE1）剂量的POCUS组）。
本研究共纳入150例患者。对照组和POCUS组的平均胎龄分别为38.6周和38.9周，平均出生体重分别为3.09 kg和3.23 kg。对照组的PGE1处方率（93.3%）高于POCUS组（71.1%；<0.001）。开始使用PGE1的时间（产前诊断）早于对照组（0.05±0.01天对1.66±3.72天；<0.001）。POCUS组使用低剂量（小于5 ng/kg·min）PGE1的患者比例更高（40.6%对8.9%；<0.001）。多因素逻辑回归分析表明，实施POCUS可显著降低PGE1的剂量。
POCUS可优化PGE1的使用，减少不必要的使用，推迟PGE1的开始使用时间，将维持剂量降至最低，并减少冲击剂量。POCUS指导提高了PGE1在TGA婴儿中的安全性和有效性。
