The Impact of Pulmonary Hypertension in Preterm Infants with Severe Bronchopulmonary Dysplasia through 1 Year.
The Impact of Pulmonary Hypertension in Preterm Infants with Severe Bronchopulmonary Dysplasia through 1 Year.
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DOI：
10.1016/j.jpeds.2018.07.035
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发表时间：
2018-12
期刊：
影响因子：
--
通讯作者：
Children's Hospital Neonatal Consortium Severe BPD Focus Group
中科院分区：
文献类型：
--
作者：
Lagatta JM;Hysinger EB;Zaniletti I;Wymore EM;Vyas-Read S;Yallapragada S;Nelin LD;Truog WE;Padula MA;Porta NFM;Savani RC;Potoka KP;Kawut SM;DiGeronimo R;Natarajan G;Zhang H;Grover TR;Engle WA;Murthy K;Children's Hospital Neonatal Consortium Severe BPD Focus Group
通过一项大型多中心队列研究，评估肺动脉高压对重度支气管肺发育不良婴儿1岁校正年龄内NICU死亡率和再入院率的影响。这是一项多中心、回顾性队列研究，纳入了1677例妊娠<32周的重度支气管肺发育不良（正压通气、鼻插管流量>2 L/min或经后36周吸入氧分数（FiO 2）>0.3）婴儿，这些婴儿入组儿童医院新生儿联盟，记录与儿科健康信息系统相关联。370/1677例（22%）婴儿发生肺动脉高压。在新生儿入院期间，肺动脉高压与死亡率相关（OR= 3.15，95%CI 2.10-4.73，p<0.001），月经后36周时呼吸机支持（60% vs 40%，p<0.001），通气持续时间（72 IQR 30-124 vs 41 IQR 17-74天，p<0.001）和较高的呼吸严重程度评分（3.6 IQR 0.4-7.0 vs 0.8 IQR 0.3-3.3，p<0.001）。出院时，肺动脉高压与气管切开术（27% vs 9%，p<0.001）、辅助供氧（84% vs 61%，p<0.001）和管饲（80% vs 46%，p<0.001）相关。校正年龄一年后，肺动脉高压与再入院频率增加相关（IRR=1.38，95%CI 1.18-1.63，p<0.001）。患有严重支气管肺发育不良相关肺动脉高压的婴儿在一岁校正年龄内的发病率和死亡率增加。这突出表明迫切需要改进诊断实践和前瞻性研究，以评估对这一高危人群的治疗。
To assess the effect of pulmonary hypertension on NICU mortality and hospital readmission through one year corrected age in infants with severe bronchopulmonary dysplasia with a large, multicenter cohort. This was a multicenter, retrospective cohort study of 1677 infants born <32 weeks’ gestation with severe bronchopulmonary dysplasia (positive pressure ventilation, >2 L/min flow by nasal cannula, or fraction of inspired oxygen (FiO2) >0.3 at 36 weeks’ postmenstrual age) enrolled in the Children’s Hospital Neonatal Consortium with records linked to the Pediatric Health Information System. Pulmonary hypertension occurred in 370/1677 (22%) infants. During the neonatal admission, pulmonary hypertension was associated with mortality (OR= 3.15, 95%CI 2.10–4.73, p<0.001), ventilator support at 36 weeks’ post-menstrual age (60% vs 40%, p<0.001), duration of ventilation (72 IQR 30–124 vs 41 IQR 17–74 days, p<0.001), and higher respiratory severity score (3.6 IQR 0.4–7.0 vs 0.8 IQR 0.3–3.3, p<0.001). At discharge, pulmonary hypertension was associated with tracheostomy (27% vs 9%, p<0.001), supplemental oxygen use (84% vs 61%, p<0.001), and tube feeds (80% vs 46%, p<0.001). Through one year corrected age, pulmonary hypertension was associated with increased frequency of readmission (IRR=1.38, 95%CI 1.18–1.63, p<0.001). Infants with severe bronchopulmonary dysplasia-associated pulmonary hypertension have increased morbidity and mortality through one year corrected age. This highlights the urgent need for improved diagnostic practices and prospective studies evaluating treatments for this high-risk population.
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影响因子：
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作者：
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