Clinical outcomes of the neonates with critical pulmonary stenosis: intrauterine versus postnatal transport.

IF 1.5 4区医学 Q2 PEDIATRICS Translational pediatrics Pub Date : 2024-07-31 Epub Date: 2024-07-23 DOI:10.21037/tp-24-42

Jufeng Zhang, Yan Chen, Zhiwei Lin, Na Jiang, Lin Zhou, Sun Chen, Hongping Xia

{"title":"Clinical outcomes of the neonates with critical pulmonary stenosis: intrauterine versus postnatal transport.","authors":"Jufeng Zhang, Yan Chen, Zhiwei Lin, Na Jiang, Lin Zhou, Sun Chen, Hongping Xia","doi":"10.21037/tp-24-42","DOIUrl":null,"url":null,"abstract":"Background: Pulmonary stenosis (PS) is one rare congenital heart disease (CHD) featuring obstruction of right ventricular outflow tract. Critical pulmonary stenosis (CPS) is neonatal PS having cyanosis and evidence of patent ductus arteriosus (PDA) dependency. There is limited data on the clinical outcomes of CPS with different modes of transportation. This study aimed to investigate clinical features and outcomes of CPS through the intrauterine transport (IT) and postnatal transport (PT).Methods: Single-center retrospective research was performed. Neonates with CPS were grouped into the IT group and PT group. Clinical characteristics and outcomes of the neonates were compared between the two groups.Results: Totally 110 neonates with PS were included in this study, 77 with CPS and 33 with non-CPS. In the infants with CPS, there were 53 and 24 in the IT and PT group respectively. Echocardiography showed that transvalvular pulmonary gradient (TVG) stayed lower in the IT group than that in the PT group {77.0 [interquartile range (IQR), 60.5-91.5] vs. 92.0 (IQR, 73.3-125.0) mmHg, P=0.006}. Levels of serum N-terminal pro-brain natriuretic peptide (NT-proBNP) and troponin I also remained lower in the IT group than those in the PT group [2,256 (IQR, 1,054-4,527) vs. 3,708 (IQR, 2,138-6,789) pg/mL, P=0.02; 0.020 (IQR, 0.011-0.034) vs. 0.042 (IQR, 0.027-0.072) ng/mL, P<0.001, respectively]. All infants with CPS received percutaneous balloon pulmonary valvuloplasty (PBPV) therapy in neonatal period and were discharged from the hospital. Length of hospital stay remained shorter in the IT group than that in the PT group [13.0 (IQR, 11.0-15.0) vs. 15.5 (IQR, 10.8-22.8) days, P=0.03].Conclusions: IT and early management after birth could effectively reduce the severity of CPS before PBPV treatment and shorten the length of hospital stay among neonates suffering from CPS.","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11320012/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Translational pediatrics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.21037/tp-24-42","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/7/23 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Pulmonary stenosis (PS) is one rare congenital heart disease (CHD) featuring obstruction of right ventricular outflow tract. Critical pulmonary stenosis (CPS) is neonatal PS having cyanosis and evidence of patent ductus arteriosus (PDA) dependency. There is limited data on the clinical outcomes of CPS with different modes of transportation. This study aimed to investigate clinical features and outcomes of CPS through the intrauterine transport (IT) and postnatal transport (PT).

Methods: Single-center retrospective research was performed. Neonates with CPS were grouped into the IT group and PT group. Clinical characteristics and outcomes of the neonates were compared between the two groups.

Results: Totally 110 neonates with PS were included in this study, 77 with CPS and 33 with non-CPS. In the infants with CPS, there were 53 and 24 in the IT and PT group respectively. Echocardiography showed that transvalvular pulmonary gradient (TVG) stayed lower in the IT group than that in the PT group {77.0 [interquartile range (IQR), 60.5-91.5] vs. 92.0 (IQR, 73.3-125.0) mmHg, P=0.006}. Levels of serum N-terminal pro-brain natriuretic peptide (NT-proBNP) and troponin I also remained lower in the IT group than those in the PT group [2,256 (IQR, 1,054-4,527) vs. 3,708 (IQR, 2,138-6,789) pg/mL, P=0.02; 0.020 (IQR, 0.011-0.034) vs. 0.042 (IQR, 0.027-0.072) ng/mL, P<0.001, respectively]. All infants with CPS received percutaneous balloon pulmonary valvuloplasty (PBPV) therapy in neonatal period and were discharged from the hospital. Length of hospital stay remained shorter in the IT group than that in the PT group [13.0 (IQR, 11.0-15.0) vs. 15.5 (IQR, 10.8-22.8) days, P=0.03].

Conclusions: IT and early management after birth could effectively reduce the severity of CPS before PBPV treatment and shorten the length of hospital stay among neonates suffering from CPS.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

患有严重肺动脉狭窄的新生儿的临床结果：宫内转运与产后转运。

背景：肺动脉狭窄（PS）是一种罕见的先天性心脏病（CHD），以右心室流出道阻塞为特征。重度肺动脉狭窄（CPS）是指新生儿肺动脉狭窄伴有紫绀和动脉导管未闭（PDA）。关于不同运输方式下 CPS 临床结果的数据有限。本研究旨在探讨宫内转运（IT）和产后转运（PT）CPS的临床特征和预后：方法：进行单中心回顾性研究。将患有 CPS 的新生儿分为 IT 组和 PT 组。比较两组新生儿的临床特征和预后：本研究共纳入 110 例 PS 新生儿，其中 77 例为 CPS 新生儿，33 例为非 CPS 新生儿。在CPS患儿中，IT组和PT组分别有53名和24名。超声心动图显示，IT 组的跨瓣肺动脉瓣膜梯度（TVG）低于 PT 组{77.0（四分位数间距（IQR），60.5-91.5）对 92.0（四分位数间距（IQR），73.3-125.0）mmHg，P=0.006}。IT 组血清 N 端前脑钠肽 (NT-proBNP) 和肌钙蛋白 I 的水平也仍然低于 PT 组[2,256（IQR，1,054-4,527）vs.3,708（IQR，1,054-4,527），P=0.006]。3,708（IQR，2,138-6,789） pg/mL，P=0.02；0.020（IQR，0.011-0.034） vs. 0.042（IQR，0.027-0.072） ng/mL，Pvs.15.5（IQR，10.8-22.8） days，P=0.03]：IT和出生后的早期管理可在PBPV治疗前有效降低CPS的严重程度，缩短CPS新生儿的住院时间。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊