Echocardiographic Parameters Predictive of Poor Outcome in Persistent Pulmonary Hypertension of the Newborn (PPHN): Preliminary Results.

Autor: Breinig S; Neonatal and Pediatric Intensive Care Unit, Children's Hospital, 330 Avenue de Grande-Bretagne, Toulouse Cedex 9, France. s.breinig@orange.fr.; INSERM, UMR 1027, SPHERE Team, Hôpital Paule de Viguier, 330 Avenue de Grande-Bretagne, TSA 70034, Toulouse, France. s.breinig@orange.fr., Dicky O; INSERM, UMR 1027, SPHERE Team, Hôpital Paule de Viguier, 330 Avenue de Grande-Bretagne, TSA 70034, Toulouse, France.; Neonatal Intensive Care Unit, Children's Hospital, 330 Avenue de Grande-Bretagne, Toulouse Cedex 9, France., Ehlinger V; INSERM, UMR 1027, SPHERE Team, Hôpital Paule de Viguier, 330 Avenue de Grande-Bretagne, TSA 70034, Toulouse, France., Dulac Y; Pediatric Cardiology, Children's Hospital, 330 Avenue de Grande-Bretagne, Toulouse Cedex 9, France., Marcoux MO; Neonatal and Pediatric Intensive Care Unit, Children's Hospital, 330 Avenue de Grande-Bretagne, Toulouse Cedex 9, France., Arnaud C; INSERM, UMR 1027, SPHERE Team, Hôpital Paule de Viguier, 330 Avenue de Grande-Bretagne, TSA 70034, Toulouse, France.; Clinical Epidemiology Unit, University Hospital Toulouse, 37 Allées Jules Guesde, 31000, Toulouse, France.
Jazyk: angličtina
Zdroj: Pediatric cardiology [Pediatr Cardiol] 2021 Dec; Vol. 42 (8), pp. 1848-1853. Date of Electronic Publication: 2021 Jul 31.
DOI: 10.1007/s00246-021-02677-z
Abstrakt: The aim is to conduct a pilot study to prospectively describe echocardiographic parameters in neonates with pulmonary hypertension (PH) managed according to current recommendations and to identify those parameters that could predict worsening of short-term outcomes. All neonates less than 28 days old with a diagnosis of PH were prospectively enrolled in a tertiary care center for 1 year. Two echocardiograms were performed by a trained neonatologist. The first echocardiogram was performed at the time of diagnosis, whereas the second was performed just after basic therapeutic optimization. The cohort included 27 neonates. Mean gestational age at birth was 36.1 weeks gestational age (WGA) (SD: 4) and mean birth weight was 2658 g (SD: 907). Six neonates (22%) died before day 28, with a median age at death of 48 h (IQR [33; 89]). Although the first echocardiogram showed no difference, the second highlighted a strong link between the persistence of right-to left-shunt and death (p = 0.002). We showed a link between right-to-left shunt and a poor outcome (death or morbidity) after therapeutic optimization among premature and full-term neonates suffering from PH. We recommend repeating echocardiography after basic therapeutic optimization and for prognostic purposes, taking into account only the second examination. Larger cohorts are needed to confirm these results.
(© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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