PDF(Pubmed)
Abstract：
BACKGROUND: Pulmonary vascular disease (PVD) and pulmonary hypertension (PH) is a significant disorder affecting prognosis of extremely preterm infants. However, there is still a lack of a consensus on the definition and optimal treatments of PH, and there is also a lack of research comparing these conditions with persistent pulmonary hypertension of newborn (PPHN), early PH, and late PH. To investigate PH in extremely preterm infants, this study compared the baseline characteristics, short-term outcomes, and treatment duration, categorized by the timing of requiring PH treatment.
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.
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.
摘要：
背景：肺血管疾病（PVD）和肺动脉高压（PH）是影响极早产儿预后的重要疾病。然而,对PH的定义和最佳治疗仍缺乏共识，也缺乏将这些情况与新生儿持续性肺动脉高压（PPHN）进行比较的研究，早期PH,迟来的PH调查极度早产儿的PH，这项研究比较了基线特征，短期结果，和治疗持续时间，按需要PH治疗的时机分类。
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。
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。
