Clinical and echocardiography predictors of response to inhaled nitric oxide in hypoxic preterm neonates
Rattachement africain : ca. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
AIM: To evaluate the clinical and echocardiography modulators of treatment response in hypoxemic preterm infants exposed to inhaled nitric oxide (iNO). METHODS: In this multicentre retrospective study, clinical parameters, including oxygenation, ventilation and haemodynamics, were collected for preterm infants <36 weeks gestation before and 2 h after initiation of iNO for acute hypoxemia. Comprehensive echocardiography, performed near the time iNO initiation, was analysed by experts blind to the clinical course. Multiple logistic regression analysis was used to identify factors associated with iNO response as defined by a reduction in the fraction of inspired oxygen by >0.20. RESULTS: A total of 213 infants met eligibility criteria, of which 73 had echocardiography data available and formed the study cohort. Response to iNO was demonstrated in 56% of patients. Younger post-natal age (odds ratio (OR) 0.94; 95% confidence interval (CI) 0.89, 0.99) and the presence of pulmonary hypertension (PH) (OR 4.47; 95% CI 1.23-11.9) were independently predictive of iNO response regardless of gestational age. Among neonates <72 h old with documented PH, iNO response was seen in 82%. The onset of a new diagnosis of severe (grade III/IV) intraventricular haemorrhage (IVH) after iNO treatment was seen in 6 of 40 patients <28 weeks' gestational age, with a greater frequency in responders (32 vs. 0%, P = 0.02). CONCLUSIONS: Positive response to iNO is greatest in the first 3 days of life and in patients with echo-confirmed PH, independent of gestational age. The association between critical illness, iNO administration and IVH in extremely premature infants may merit prospective delineation.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Clinical and echocardiography predictors of response to inhaled nitric oxide in hypoxic preterm neonates
- Date Crossref
- 08/12/2018
- Éditeur
- Wiley
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
-
Mount Sinai Hospital Department of Pediatrics pays non établi dans la noticeÉtablissement de santé
-
University of Toronto Department of Pediatrics pays non établi dans la noticeUniversité ou école supérieure
-
Hospital for Sick Children Division of Neonatology pays non établi dans la noticeÉtablissement de santé
-
Sunnybrook Health Science Centre pays non établi dans la noticeÉtablissement de santé
-
Health Sciences Centre pays non établi dans la noticeÉtablissement de santé
-
Department of Pediatrics pays non établi dans la noticeInstitution
Department of Pediatrics — Mount Sinai Hospital, Department of Pediatrics — University of Toronto et Division of Neonatology — Hospital for Sick Children, avec 3 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.