The impact of integrated evaluation of hemodynamics using targeted neonatal echocardiography with indices of tissue oxygenation: a new approach
The impact of integrated evaluation of hemodynamics using targeted neonatal echocardiography with indices of tissue oxygenation: a new approach
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DOI：
10.1038/jp.2016.257
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发表时间：
2017-05-01
影响因子：
2.9
通讯作者：
Seshia, M. M.
中科院分区：
文献类型：
--
作者：
Elsayed, Y. N.;Amer, R.;Seshia, M. M.
目的：研究综合评价血流动力学（IEH）的影响，有针对性的新生儿超声心动图，再加上区域组织氧合，分数氧提取使用近红外光谱对婴儿的管理compromised血流动力学。研究设计：回顾性队列比较两组婴儿的血流动力学受损。EPOCH 1：未接受IEH（2012年1月至2014年3月）; EPOCH 2：接受IEH（2014年4月至2015年12月）。主要结果是恢复的时间。结果：共纳入340名婴儿，其中158名婴儿接受了IEH，中位数（IQR）为2（1至3）评价。评估原因包括PDA（60%）、体循环受损（14%）和临床疑似肺动脉高压（22%）。IEH组体循环受损患者的恢复时间中位数（IQR）较短，为32 h与非IEH组71 h比较，（36 - 96），肺动脉高压63 h IEH组与68 h组比较，（24 ~ 240）例未发生IEH的早产儿PDA相关并发症，IEH组PDA相关并发症较少。IEH与血流动力学受损婴儿的临床恢复时间较短相关
OBJECTIVE: To study the impact of integrated evaluation of hemodynamics (IEH) using targeted neonatal echocardiography, together with regional tissue oxygenation, fractional oxygen extraction using near-infrared spectroscopy on the management of infants with compromised hemodynamics.STUDY DESIGN: Retrospective cohort comparison of two groups of infants with compromised hemodynamics. EPOCH 1: did not undergo IEH (January 2012 to March 2014); EPOCH 2: underwent IEH (April 2014 to December 2015). The primary outcome was the time to recovery.RESULTS: In all, 340 infants were included; 158 underwent IEH with a median (IQR) of 2 (1 to 3) evaluations per infant. Reasons for assessment included PDA (60%), compromised systemic circulation (14%) and clinically suspected pulmonary hypertension (22%). The time to recovery was shorter in IEH group in patients with compromised systemic circulation median (IQR), 32 h (24 to 63) compared with none IEH group 71 h (36 to 96), pulmonary hypertension 63 h (14.2 to 102) in IEH group compared with 68 h (24 to 240) in none IEH group, there were fewer PDA-related complications in preterm infants with PDA in IEH group.CONCLUSION: IEH was associated with shorter time to clinical recovery in infants with compromised hemodynamics