Echocardiographic detection of pulmonary hypertension in extremely low birth weight infants with bronchopulmonary dysplasia requiring prolonged positive pressure ventilation
Echocardiographic detection of pulmonary hypertension in extremely low birth weight infants with bronchopulmonary dysplasia requiring prolonged positive pressure ventilation
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DOI：
10.1038/jp.2010.213
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发表时间：
2011-10-01
影响因子：
2.9
通讯作者：
Shah, T. A.
中科院分区：
文献类型：
--
作者：
Slaughter, J. L.;Pakrashi, T.;Shah, T. A.
目的：本研究的目的是描述超声心动图诊断的极低出生体重（ELBW）合并支气管肺发育不良（BPD）需要长时间正压通气（PPV）的婴儿肺动脉高压（PH）的流行病学，并确定PH与这些患者死亡率之间的独立关系。研究设计：我们的回顾性队列包括2003-2009年在俄亥俄州辛辛那提住院的低体重婴儿，BPD需要长时间PPV，记录在国家儿童健康和人类发展研究所新生儿研究网络数据库中。通过图表回顾，我们构建了一个逻辑回归模型来了解PH对需要延长PPV的BPD婴儿死亡率的影响。结果：我们在1156例ELBW婴儿中确定了216例（19%）BPD患者需要延长PPV。在这些患者中，41%在4周后接受了超声心动图检查，37%显示出PH值。Logistic回归分析表明，与没有超声心动图PH值的BPD患儿相比，需要延长PPV的BPD患儿死亡的可能性是需要延长PPV的BPD患儿的4倍（校正优势比：4.6,95%置信区间：1.3-16.5）。肺动脉高压似乎是需要延长PPV的BPD婴儿死亡的一个重要的独立决定因素。Journal of Perinatology (2011) 31635 -640；doi: 10.1038 / jp.2010.213;2011年2月10日在线发布
Objective: The goal of this study was to delineate the epidemiology of echocardiographically diagnosed pulmonary hypertension (PH) in extremely low birth weight (ELBW) infants with bronchopulmonary dysplasia (BPD) requiring prolonged positive pressure ventilation (PPV), and to determine the independent relationship between PH and mortality in these patients.Study Design: Our retrospective cohort included ELBW infants, with BPD requiring prolonged PPV, hospitalized in Cincinnati, Ohio during 2003-2009, as recorded in the National Institute of Child Health and Human Development Neonatal Research Network Database. Following chart review, a logistic regression model was constructed to understand the contribution of PH to mortality in infants with BPD requiring prolonged PPV.Result: We identified 216 patients (19%) with BPD requiring prolonged PPV among 1156 ELBW infants. Of these patients, 41% received echocardiography after 4 weeks of life, with 37% showing evidence of PH. Logistic regression analysis demonstrated that infants with BPD requiring prolonged PPV, with PH detectable by echocardiogram, were four times more likely to die (adjusted odds ratio): 4.6, 95% confidence interval: 1.3-16.5) when compared with infants with BPD requiring prolonged PPV without echocardiographic evidence of PH.Conclusion: Pulmonary hypertension appears to be an important, independent determinant of death in infants with BPD requiring prolonged PPV. Journal of Perinatology (2011) 31,635-640; doi:10.1038/jp.2010.213; published online 10 February 2011