METHODS: This study retrospectively analyzed extremely preterm infants admitted to a single tertiary center. Between 2018 and 2022, infants with clinical or echocardiographic diagnosis of PH who required treatment were divided into three groups based on the timing of treatment initiation: initial 3 days (extremely early-period), from day 4 to day 27 (early-period), and after day 28 (late-period). The study compared the outcomes, including mortality rates, bronchopulmonary dysplasia (BPD) severity, PH treatment duration, and oxygen therapy duration, among the three groups.
RESULTS: Among the 157 infants, 67 (42.7%) were treated for PH during their stay. Of these, 39 (57.3%) were treatment in extremely early, 21 (31.3%) in early, and seven (11.4%) in late periods. No significant differences were observed in maternal factors, neonatal factors, or morbidity between the three groups. However, infants who received extremely early-period treatment had a higher mortality rate, but shorter duration of noninvasive respiratory support, oxygen therapy, and PH medication use. On the other hand, the late-period treatment group received longer durations of respiratory support and treatment.
CONCLUSIONS: This study revealed differences in mortality rates, respiratory outcomes, and treatment duration between the three groups, suggesting varying pathophysiologies over time in extremely preterm infants.
方法:本研究回顾性分析了单一三级中心收治的极早产儿。在2018年至2022年之间,根据治疗开始时间将临床或超声心动图诊断为PH的婴儿分为三组:最初3天(极早期),从第4天到第27天(早期),在第28天(后期)之后。这项研究比较了结果,包括死亡率,支气管肺发育不良(BPD)的严重程度,PH处理时间,和氧疗持续时间,在三个群体中。
结果:在157名婴儿中,67例(42.7%)在逗留期间接受了PH治疗。其中,39例(57.3%)在极早期治疗,21(31.3%)早期,后期有7个(11.4%)。在母体因素方面没有观察到显著差异,新生儿因素,或三组之间的发病率。然而,接受极早期治疗的婴儿死亡率更高,但是无创呼吸支持的持续时间较短,氧疗,和PH药物使用。另一方面,后期治疗组接受更长持续时间的呼吸支持和治疗.
结论:这项研究揭示了死亡率的差异,呼吸结果,三组之间的治疗时间,提示极端早产儿随时间变化的病理生理。