Developmental outcomes in persistent pulmonary hypertension treated with nitric oxide therapy
Developmental outcomes in persistent pulmonary hypertension treated with nitric oxide therapy
复制标题
DOI：
10.1111/j.1442-200x.2008.02664.x
复制
发表时间：
2009-02-01
影响因子：
1.4
通讯作者：
Harada, Kensuke
中科院分区：
文献类型：
--
作者：
Hosono, Shigeharu;Ohno, Tutomu;Harada, Kensuke
本研究的目的是评估新生儿持续性肺动脉高压（PPHN）引入吸入型一氧化氮（i-NO）治疗前后3年的听觉和神经发育结局，并检测影响预后不良的临床因素。对26例肺氧合指数(OI) >= 25的PPHN幸存者进行回顾性历史队列研究（未给予i-NO治疗的13例为对照组；给予i-NO治疗的13例为i-NO组）。评估6个月和12个月时的听觉脑干反应（ABR）和3岁时的神经发育结果。i-NO组患儿6月龄ABR异常1例，对照组患儿6例（P = 0.04）。1岁时，i-NO组仍有1例，对照组6例中仍有2例存在ABR异常。在i-NO组中，有2名儿童出现神经发育异常，而在3年随访中，对照组有5名儿童出现神经发育异常。对照组2例，i-NO组3岁时无听力损失。睡眠不足（P = 0.04）和肌酸磷酸激酶升高（P = 0.04）是神经发育异常的预测指标。通过引入i-NO治疗来避免过度的低呼吸可能会减少ABR和神经发育异常。
The aim of the present study was to assess 3 year auditory and neurodevelopmental outcomes of persistent pulmonary hypertension of the newborn (PPHN) before and after introducing inhaled nitric oxide (i-NO) therapy, and to detect the clinical factors affecting poor outcome.A retrospective historical cohort study of 26 survivors with PPHN with oxygenation index (OI) >= 25 (13 infants without i-NO therapy, control group; 13 with i-NO therapy, i-NO group) was performed. Auditory brainstem response (ABR) at 6 and 12 months and neurodevelopmental outcomes at 3 years of age were evaluated.ABR abnormalities at 6 months were observed in one infant in the i-NO group and six in the control group (P = 0.04). At 1 year, one infant in the i-NO group and two of six infants in the control group still had ABR abnormality. In the i-NO group, two children had abnormal neurodevelopmental outcomes, as compared with five children in the control group at 3 year follow up. Two children in the control group and no children in the i-NO group had hearing loss at 3 years of age. Hypocapnea (P = 0.04) and elevated creatine phosphokinase (P = 0.04) were found to be most predictive for neurodevelopmental abnormality.Avoidance of excessive hypocapnea via introduction of i-NO therapy might reduce both ABR and neurodevelopmental abnormalities.