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태변 흡입 증후군 환아에서 신생아 지속성 폐고혈압증 발생과 관련된 동반 인자

Comorbid Risk Factors of Persistent Pulmonary Hypertension of the Newborn in Infants with Meconium Aspiration Syndrome

최민규|송영환|심규홍|최명재|이은채
대한신생아학회 (THE KOREAN SOCIETY OF NEONATOLOGY)|2014.08|Neonatal medicine|제21권 제3호|pp. 166-171

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키워드

HypotensionMeconium aspiration syndromePersistent pulmonary hypertension of the newborn

초록

Purpose: Persistent pulmonary hypertension (PPHN) is considered an important prognostic factor in meconium aspiration syndrome (MAS). The aim of this study was to determine the comorbid risk factors for PPHN in infants with MAS. Methods: We retrospectively analyzed 60 infants diagnosed with MAS and admitted to the neonatal intensive care unit of the Sanggye Paik Hospital from January 2007 to April 2013. There were 28 infants (47%) with PPHN and 32 infants (53%) without PPHN. Clinical characteristics, laboratory findings within 24 hours after birth, and initial capillary blood gas analysis results were compared between infants with and without PPHN. Results: Incidence of PPHN was associated with the severity of MAS (P<0.001). The PPHN group had a greater incidence of hypotension and hypoxic-ischemic encephalopathy within 24 hours of birth compared to the non-PPHN group. The PPHN group also had a lower initial pH. However, there was no significant difference for laboratory findings within 24 hours of birth and initial capillary blood gas analysis. In the multivariate analysis, hypotension within 24 hours of birth (P=0.046, odds ratio 11.494, 95% confidence interval 1.048–125.00) was found to be a significant comorbid factor for PPHN in infants with MAS. Conclusion: Infants with MAS who develop hypotension within 24 hours of birth should be closely monitored for development of PPHN.

Abstract

Purpose: Persistent pulmonary hypertension (PPHN) is considered an important prognostic factor in meconium aspiration syndrome (MAS). The aim of this study was to determine the comorbid risk factors for PPHN in infants with MAS. Methods: We retrospectively analyzed 60 infants diagnosed with MAS and admitted to the neonatal intensive care unit of the Sanggye Paik Hospital from January 2007 to April 2013. There were 28 infants (47%) with PPHN and 32 infants (53%) without PPHN. Clinical characteristics, laboratory findings within 24 hours after birth, and initial capillary blood gas analysis results were compared between infants with and without PPHN. Results: Incidence of PPHN was associated with the severity of MAS (P<0.001). The PPHN group had a greater incidence of hypotension and hypoxic-ischemic encephalopathy within 24 hours of birth compared to the non-PPHN group. The PPHN group also had a lower initial pH. However, there was no significant difference for laboratory findings within 24 hours of birth and initial capillary blood gas analysis. In the multivariate analysis, hypotension within 24 hours of birth (P=0.046, odds ratio 11.494, 95% confidence interval 1.048–125.00) was found to be a significant comorbid factor for PPHN in infants with MAS. Conclusion: Infants with MAS who develop hypotension within 24 hours of birth should be closely monitored for development of PPHN.

참고문헌 (26)

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