■新生儿的持续性肺动脉高压(PPHT)是一种循环转换障碍,导致高的肺血管阻力,肺外从右到左分流导致低氧血症。在这项研究中,我们的目标是评估风险因素,管理治疗,在过去的6年中,我们的新生儿重症监护病房(NICU)患者因PPHT而死亡。
■在2017年1月至2022年11月期间在NICU诊断为PPHT并随访的患者被纳入研究。社会人口特征,可能导致肺动脉高压的诊断,先天性异常的存在,呼吸支持治疗的持续时间和医院随访,给予PPHT的治疗,和死亡率进行了评估。
■在21例诊断为持续性肺动脉高压的患者中,其中9人(42.9%)为男性。患者的平均孕龄为37.6±3.7周,他们的出生体重为3006±819克。1分钟和5分钟的APGAR评分分别为4(2-7)和6(3-8),分别。产前期间的危险因素包括胎儿窘迫(38.1%),羊水过少(23.8%),宫内生长受限(23.8%),妊娠期糖尿病(14.3%),先兆子痫(4.8%),绒毛膜羊膜炎(4.8%)。对于需要呼吸支持的病例,有创机械通气的中位持续时间为20.1天,而无创通气的中位持续时间为3.7天。诊断为持续肺动脉高压的患者在76.2%的病例中接受了吸入一氧化氮(iNO)治疗,米力农占66.7%的病例,西地那非占52.4%,和伊洛前列素占14.3%。病人的住院时间为38.4天,9例(42.9%)患者死亡。死亡的患者患有严重的PPHT并伴有胎儿炎症反应综合征(FIRS),先天性心脏病,肺发育不全,气胸,缺氧缺血性脑病(HIE),和先天性异常。
■持续肺动脉高压,以严重低氧血症为特征,是需要早期干预的新生儿紧急情况,有效治疗根本原因,以防止潜在的短期和长期发病率和死亡率。在诊断为PPHT的患者中有效治疗根本原因可以降低发病率和死亡率。避免重大异常患者的损失是不可避免的,严重的合并症,和无法预防的器官功能障碍。
UNASSIGNED: Persistent pulmonary hypertension (PPHT) of the newborn is a disorder of circulatory transition resulting in high pulmonary vascular resistance with extrapulmonary right-to-left shunts causing hypoxemia. In this study, our aim was to evaluate the risk factors, administered treatments, and mortality of patients followed in our neonatal intensive care unit (NICU) due to PPHT over the past six years.
UNASSIGNED: Patients diagnosed with PPHT and followed in the NICU between January 2017 and November 2022 were included in the study. The sociodemographic characteristics, diagnoses that could lead to pulmonary hypertension, the presence of congenital anomalies, the duration of respiratory support treatment and hospital follow-up, treatments administered for PPHT, and mortality rates were evaluated.
UNASSIGNED: Out of 21 patients diagnosed with persistent pulmonary hypertension, 9 of them (42.9%) were male. The mean gestational age of the patients was 37.6±3.7 weeks, and their birth weight was 3006±819grams. The APGAR scores at 1 and 5 minutes were 4(2-7) and 6(3-8), respectively. Risk factors during the antenatal period included fetal distress (38.1%), oligohydramnios (23.8%), intrauterine growth restriction (23.8%), gestational diabetes (14.3%), preeclampsia (4.8%), and chorioamnionitis (4.8%). The median duration of invasive mechanical ventilation for cases requiring respiratory support was 20.1 days, while the median duration of non-invasive ventilation was 3.7 days. Patients with a diagnosis of persistent pulmonary hypertension were treated with inhaled nitric oxide (iNO) in 76.2% of cases, milrinone in 66.7% of cases, sildenafil in 52.4% of cases, and iloprost in 14.3% of cases. The length of hospital stay for patients was 38.4 days, and 9 (42.9%) patients died. The patients who died had severe PPHT along with fetal inflammatory response syndrome (FIRS), congenital heart disease, pulmonary hypoplasia, pneumothorax, hypoxic-ischemic encephalopathy (HIE), and congenital anomalies.
UNASSIGNED: Persistent pulmonary hypertension, characterized by severe hypoxemia, is a neonatal emergency that necessitates early intervention, effective treatment of the underlying cause to prevent potential short-term and long-term morbidities and mortality. Effective treatment of the underlying cause in patients diagnosed with PPHT could reduce morbidity and mortality. It is inevitable to avoid the loss of patients with major abnormalities, severe comorbidities, and unpreventable organ dysfunctions.