Journal article
Practices and Outcomes from a Prospective, Multicenter Registry for Preterm Newborns with Pulmonary Hypertension
The Journal of pediatrics, Vol.262, pp.113614-113614
11/01/2023
DOI: 10.1016/j.jpeds.2023.113614
PMID: 37478902
Abstract
To describe current treatment practices of preterm infants with early hypoxemic respiratory failure (HRF) and pulmonary hypertension (PH) and their association with patient outcomes.
We developed a prospective, observational, multicenter clinical registry of preterm newborns < 34 weeks’ gestation with HRF and PH, based on either clinical or echocardiographic evidence during the first 72 hours of life from 28 neonatal intensive care units in the United States from 2017 through 2022. The primary endpoint was mortality among those who did or did not receive PH-targeted treatment and secondary endpoints included comparisons of major morbidities. Variables were compared using t-tests, Wilcoxon rank-sum tests, Fishers exact tests, and chi-squared tests.
We analyzed the results of 224 preterm infants enrolled in the registry. 84% (188/224) received PH-targeted treatment, most commonly inhaled nitric oxide (iNO). Early mortality in this cohort was high, as 33% (71/224) of this sample died in the first month of life, and 77% of survivors (105/137) developed bronchopulmonary dysplasia (BPD). Infants who received PH-targeted treatment had higher oxygenation indices at time of enrollment (28.16 (IQR 13.94, 42.5) vs. 15.46 (IQR 11.94, 26.15); p=0.0064). Patient outcomes did not differ between those who did or did not receive PH-targeted therapy.
Early onset HRF with PH in preterm infants is associated with a high early mortality and a high risk of developing BPD. iNO is commonly used to treat early onset PH in preterm infants with HRF. In comparison with untreated infants with lower oxygenation indices, iNO treatment in severe PH may prevent poorer outcomes.
Details
- Title: Subtitle
- Practices and Outcomes from a Prospective, Multicenter Registry for Preterm Newborns with Pulmonary Hypertension
- Creators
- Nicolle Fernández Dyess - University of Colorado DenverClaire Palmer - University of Colorado DenverRoger F. Soll - University of VermontReese H. Clark - Sunrise Communications AGSteven H. Abman - University of Colorado DenverJohn P. Kinsella - University of Colorado DenverPriscilla Joe - University of California, San FranciscoElizabeth Fong-Deleon - Children's Hospital of PhiladelphiaParesh Pandit - Children's Hospital of PhiladelphiaJacquelyn Evans - Children's Hospital of PhiladelphiaPuneet Jairath - WellSpan HealthErlinda Manalo - Sutter Medical CenterLisa McGill-Vargas - Providence Sacred Heart Medical CenterAnthony Piazza - Emory UniversityKim Parsons - Emory UniversityBradley Yoder - University of UtahAna Mankouski - University of UtahBob White - Memorial HospitalClarissa Gervasio - Las VegasGregory Sokol - Indiana UniversityCatalina Bazacliu - University of FloridaJinny Lavezzi - St. Luke’s Hospital, Kansas CityMarkus Tauscher - Saint Vincent Health SystemSarah Taylor - Yale UniversityMitchell Goldstein - Loma Linda UniversityZahi Zeidan - University of NebraskaVijay Nama - Baylor College of MedicineJose Perez - Orlando HealthJoaquim Pinheiro - Albany Medical Center HospitalKaashif Ahmad - Methodist Children’s HospitalMaria Pierce - Children's Hospital of San AntonioAnthony Rudine - St. David’s, TexasBrian Scottoline - Oregon Health and Science UniversityKrisa Van Meurs - StanfordShazia Bhombal - StanfordJorge Perez - Baptist Health South FloridaGloria Pryhuber - University of RochesterRajiv Devanagondi - University of RochesterJim White - University of RochesterPatrick McNamara - University of IowaPreterm Newborn Pulmonary Hypertension Registry Study Group
- Resource Type
- Journal article
- Publication Details
- The Journal of pediatrics, Vol.262, pp.113614-113614
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.jpeds.2023.113614
- PMID
- 37478902
- ISSN
- 0022-3476
- eISSN
- 1097-6833
- Language
- English
- Date published
- 11/01/2023
- Academic Unit
- Cardiology; Stead Family Department of Pediatrics; Neonatology; Internal Medicine
- Record Identifier
- 9984772257302771
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