An Analysis of Time to Improvement in Oxygenation in Japanese Preterm and Late Preterm or Term Neonates With Hypoxic Respiratory Failure and Pulmonary Hypertension
| Autor: | Shannon Escalante, Jim L Potenziano, Hajime Togari, William D. Rhine, Satoshi Suzuki |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Oxygenation index Hypertension Pulmonary Gestational Age 02 engineering and technology 030204 cardiovascular system & hematology Nitric Oxide Nitric oxide 03 medical and health sciences chemistry.chemical_compound 020210 optoelectronics & photonics 0302 clinical medicine Japan Administration Inhalation 0202 electrical engineering electronic engineering information engineering medicine Humans Pharmacology (medical) Hypoxia Pharmacology business.industry Mortality rate Infant Newborn Gestational age Oxygenation medicine.disease Pulmonary hypertension Discontinuation chemistry Respiratory failure Anesthesia Female Respiratory Insufficiency business |
| Zdroj: | Clinical Therapeutics. 41:910-919 |
| ISSN: | 0149-2918 |
| DOI: | 10.1016/j.clinthera.2019.03.008 |
| Popis: | We analyzed data from an ongoing registry to determine time to improvement in oxygenation in preterm and late preterm or term neonates with hypoxic respiratory failure and pulmonary hypertension receiving inhaled nitric oxide (iNO) in Japan.Registry neonates received iNO ≤7 days after birth (February 26, 2010, to October 9, 2012). Efficacy and safety profile data were collected up to 96 h after iNO initiation and, if necessary, every 24 h thereafter and before iNO discontinuation. Patients were stratified by gestational age (GA), oxygenation index (OI), and shunt direction at baseline.Data were evaluated for 1106 neonates (431 with a GA34 weeks and 675 with a GA of ≥34 weeks). Sixty percent of patients had improved OI; rates were similar for those with GAs of34 versus ≥34 weeks (61% vs 59%). Overall, mean time to improvement was 11.4 h and tended to be shorter in the groups with a GA34 weeks versus ≥34 weeks (9.2 vs 12.9 h). Thirty percent of responding neonates required1 h to achieve improvement in oxygenation. Neonates with higher baseline OI had the greatest decrease in OI during the first hour of treatment. The mortality rate was higher among iNO-treated patients with a baseline OI ≥25 versus those with OI ≥15 to25 (25% vs 12%; P = 0.0073).iNO treatment provided acute, sustained improvement in oxygenation in neonates with GAs34 and ≥34 weeks; 70% of patients had improvement within 1 h, but the remaining 30% took1 h to respond. Initiation of iNO at lower OIs was associated with reduced mortality compared with higher OI. |
| Databáze: | OpenAIRE |
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