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

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 ol...

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Autores principales: Breinig, Sophie, Dicky, Odile, Ehlinger, Virginie, Dulac, Yves, Marcoux, Marie-Odile, Arnaud, Catherine
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8324438/
https://www.ncbi.nlm.nih.gov/pubmed/34331558
http://dx.doi.org/10.1007/s00246-021-02677-z
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author Breinig, Sophie
Dicky, Odile
Ehlinger, Virginie
Dulac, Yves
Marcoux, Marie-Odile
Arnaud, Catherine
author_facet Breinig, Sophie
Dicky, Odile
Ehlinger, Virginie
Dulac, Yves
Marcoux, Marie-Odile
Arnaud, Catherine
author_sort Breinig, Sophie
collection PubMed
description 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00246-021-02677-z.
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spelling pubmed-83244382021-08-02 Echocardiographic Parameters Predictive of Poor Outcome in Persistent Pulmonary Hypertension of the Newborn (PPHN): Preliminary Results Breinig, Sophie Dicky, Odile Ehlinger, Virginie Dulac, Yves Marcoux, Marie-Odile Arnaud, Catherine Pediatr Cardiol Original Article 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00246-021-02677-z. Springer US 2021-07-31 2021 /pmc/articles/PMC8324438/ /pubmed/34331558 http://dx.doi.org/10.1007/s00246-021-02677-z Text en © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Original Article
Breinig, Sophie
Dicky, Odile
Ehlinger, Virginie
Dulac, Yves
Marcoux, Marie-Odile
Arnaud, Catherine
Echocardiographic Parameters Predictive of Poor Outcome in Persistent Pulmonary Hypertension of the Newborn (PPHN): Preliminary Results
title Echocardiographic Parameters Predictive of Poor Outcome in Persistent Pulmonary Hypertension of the Newborn (PPHN): Preliminary Results
title_full Echocardiographic Parameters Predictive of Poor Outcome in Persistent Pulmonary Hypertension of the Newborn (PPHN): Preliminary Results
title_fullStr Echocardiographic Parameters Predictive of Poor Outcome in Persistent Pulmonary Hypertension of the Newborn (PPHN): Preliminary Results
title_full_unstemmed Echocardiographic Parameters Predictive of Poor Outcome in Persistent Pulmonary Hypertension of the Newborn (PPHN): Preliminary Results
title_short Echocardiographic Parameters Predictive of Poor Outcome in Persistent Pulmonary Hypertension of the Newborn (PPHN): Preliminary Results
title_sort echocardiographic parameters predictive of poor outcome in persistent pulmonary hypertension of the newborn (pphn): preliminary results
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8324438/
https://www.ncbi.nlm.nih.gov/pubmed/34331558
http://dx.doi.org/10.1007/s00246-021-02677-z
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