Comparison between Patients with Persistent Pulmonary Hypertension of Neonates Concomitant with Parenchymal Lung Disease and Idiopathic Persistent Pulmonary Hypertension of Neonates
4
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: We aimed to compare the clinical characteristics between neonates with persistent pulmonary hypertension of neonates (PPHN) with parenchymal lung disease (PLD) and those with idiopathic PPHN. Methods: We reviewed the medical records of 67 neonates with gestational ages not lesser than 34+0 weeks who were born at Inje University Sanggye Paik Hospital between June 1, 2005 and December 31, 2016. We excluded 10 neonates who presented with congenital anomalies (n=3), dextrocardia (n=1), triple X syndrome (n=1), death before treatment (n=1), neonatal asphyxia (n=2), and congenital diaphragmatic hernia (n=2). Neonates were categorized into 2 groups—PPHN with PLD (PLD group, those diagnosed with PLD such as respiratory distress syndrome or meconium aspiration syndrome, n=36) and idiopathic PPHN (idiopathic group, n=21). We compared the clinical characteristics, treatment, and laboratory findings between the groups. Results: The PLD group neonates showed a greater requirement for positive pressure ventilation in the delivery room, higher frequency of meconium staining of amniotic fluid, and greater need for surfactant application than those belonging to the idiopathic group. In contrast, epinephrine use was more common in the idiopathic PPHN group than in the PLD group. The 1-minute Apgar score and pH observed on initial capillary blood gas analysis were lower in the PLD than in the idiopathic group. Severity scores were higher in the idiopathic than in the PLD group 4–7 days after birth. Conclusion: In our study, an overall simplified severity score in the first week after birth was higher in the idiopathic than in the PLD group. These results were particularly statistically significant over postnatal days 4–7.
Abstract
Purpose: We aimed to compare the clinical characteristics between neonates with persistent pulmonary hypertension of neonates (PPHN) with parenchymal lung disease (PLD) and those with idiopathic PPHN. Methods: We reviewed the medical records of 67 neonates with gestational ages not lesser than 34+0 weeks who were born at Inje University Sanggye Paik Hospital between June 1, 2005 and December 31, 2016. We excluded 10 neonates who presented with congenital anomalies (n=3), dextrocardia (n=1), triple X syndrome (n=1), death before treatment (n=1), neonatal asphyxia (n=2), and congenital diaphragmatic hernia (n=2). Neonates were categorized into 2 groups—PPHN with PLD (PLD group, those diagnosed with PLD such as respiratory distress syndrome or meconium aspiration syndrome, n=36) and idiopathic PPHN (idiopathic group, n=21). We compared the clinical characteristics, treatment, and laboratory findings between the groups. Results: The PLD group neonates showed a greater requirement for positive pressure ventilation in the delivery room, higher frequency of meconium staining of amniotic fluid, and greater need for surfactant application than those belonging to the idiopathic group. In contrast, epinephrine use was more common in the idiopathic PPHN group than in the PLD group. The 1-minute Apgar score and pH observed on initial capillary blood gas analysis were lower in the PLD than in the idiopathic group. Severity scores were higher in the idiopathic than in the PLD group 4–7 days after birth. Conclusion: In our study, an overall simplified severity score in the first week after birth was higher in the idiopathic than in the PLD group. These results were particularly statistically significant over postnatal days 4–7.
참고문헌 (31)
- Levin DL, "Persistent pulmonary hypertension of the newborn infant", J Pediatr, 89, pp.626~630 (1976)
- 이연경, "신생아의 지속성 폐동맥 고혈압증에서 Sildenafil 치료 경험", Neonatal medicine, 18(1), pp.124~129 (2011), 대한신생아학회
- Walsh MC, "Persistent pulmonary hypertension of the newborn. Rational therapy based on pathophysiology", Clin Perinatol, 28, pp.609~627 (2001)
- Rudolph AM, "High pulmonary vascular resistance after birth:I. Pathophysiologic considerations and etiologic classification", Clin Pediatr (Phila), 19, pp.585~590 (1980)
- Geggel RL, "The structural basis of PPHN", Clin Perinatol, 11, pp.525~549 (1984)
- Bendapudi P, "Diagnosis and management of persistent pulmonary hypertension of the newborn", Paediatr Respir Rev, 16, pp.157~161 (2015)
- Jain A, "Persistent pulmonary hypertension of the newborn: Advances in diagnosis and treatment", Semin Fetal Neonatal Med, 20, pp.262~271 (2015)
- Sweet DG, "European consensus guidelines on the management of respiratory distress syndrome - 2016 update", Neonatology, 111, pp.107~125 (2017)
- Dargaville PA, "The epidermiology of meconium aspiration syndrome: incidence, risk factors, therapies, and outcome", Pediatrics, 117, pp.1712~1721 (2006)
- Keszler M, "Severe respiratory failure after elective repeat cesarean delivery: a potentially preventable condition leading to extracorporeal membrane oxygenation", Pediatrics, 89, pp.670~672 (1992)
- Phelan JP, "Amniotic fluid volume assessment with the four-quadrant technique at 36-42weeks' gestation", J Reprod Med, 32, pp.540~542 (1987)
- Visintin C, "Management of hypertensive disorders during pregnancy: summary of NICE guidance", BMJ, 341, pp.c2207~ (2010)
- "Practice bulletin No. 180 summary: gestational diabetes mellitus", Obstet Gynecol, 130, pp.244~246 (2017)
- "Practice bulletin No. 139: premature rupture of membranes", Obstet Gynecol, 122, pp.918~930 (2013)
- Sarnat HB, "Neonatal encephalopathy following fetal distress. A clinical and electroencephalographic study", Arch Neurol, 33, pp.696~705 (1976)
- Volpe JJ, "Intraventricular hemorrhage and brain injury in the premature infant. Diagnosis, prognosis, and prevention", Clin Perinatol, 16, pp.387~411 (1989)
- Bone RC, "Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis", Chest, 101, pp.1644~1655 (1992)
- Adamkin DH, "Postnatal glucose homeostasis in late-preterm and term infants", Pediatrics, 127, pp.575~579 (2011)
- Ogilvy-Stuart AL, "Management of hyperglycaemia in the preterm infant", Arch Dis Child Fetal Neonatal Ed, 95, pp.F126~F131 (2010)
- Jain A, "Hypocalcemia in the newborn", Indian J Pediatr, 77, pp.1123~1128 (2010)
- Barletta GM, "Acute renal failure in children and infants", Curr Opin Crit Care, 10, pp.499~504 (2004)
- Mhanna MJ, "Respiratory severity score and extubation readiness in very low birth weight infants", Pediatr Neonatol, pp.006~ (2017)[DOI]
- Ballard RA, "Inhaled nitric oxide in preterm infants undergoing mechanical ventilation", N Engl J Med, 355, pp.343~353 (2006)
- 최창원, "중증 태변흡입증후군의 임상적 특성", Korean Journal of Pediatrics, 51(7), pp.713~721 (2008), 대한소아과학회
- Steurer MA, "Persistent pulmonary hypertension of the newborn in late preterm and term infants in California", Pediatrics, 139 (2017)[DOI]
- Kim SD, "Predictors of clinical outcome in the newborn of persistant pulmonary hypertension treated with inhaled nitric oxide", J Korean Soc Neonatol, 9, pp.133~140 (2002)
- Nakwan N, "Acute kidney injury and pneumothorax are risk factors for mortality in persistent pulmonary hypertension of the newborn in Thai neonates", J Matern Fetal Neonatal Med, 29, pp.1741~1746 (2016)
- Edwards MO, "Respiratory distress of the term newborn infant", Paediatr Respir Rev, 14, pp.29~36 (2013)
- Zubrow AB, "Determinants of blood pressure in infants admitted to neonatal intensive care units: a prospective multicenter study", J Perinatol, 15, pp.470~479 (1995)
- Lotze A, "Multicenter study of surfactant (beractant) use in the treatment of term infants with severe respiratory failure", J Pediatr, 132, pp.40~47 (1998)
- Choudhary M, "To study prevalence of persistent pulmonary hypertension in newborn with meconium aspiration syndrome in western Rajasthan, India: a prospective observational study", J Matern Fetal Neonatal Med, 29, pp.324~327 (2016)