[新生儿重症监护病房动脉高血压患病率]。

Q3 Medicine Revista Chilena de Pediatria-Chile Pub Date : 2020-12-01 Epub Date: 2020-10-08 DOI:10.32641/rchped.vi91i6.26974
Alejandro Balestracci, Marina Andrea Capone, Ismael Toledo, Sebastián Sticotti
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引用次数: 0

摘要

新生儿重症监护病房(NICU)的新生儿高血压患病率在3%至9%之间。然而,目前没有关于拉丁美洲的数据。目的:估计新生儿高血压的患病率,并评估其与先前相关的病因的关系。患者和方法:横断面研究。所有在一年内入住NICU的患者被纳入,不包括那些转移到心血管NICU的患者。记录了以下产妇和新生儿变量:产妇动脉高血压、分娩类型、胎龄、年龄、性别、出生体重、Apgar评分、皮质类固醇肺成熟史、脐管插管以及入住NICU的原因、药物和住院期间的并发症。用自动测压仪测量血压,根据胎龄标准确定新生儿高血压。患病率以百分比表示(置信区间95%,CI95%)。描述性数据报告为中位数(范围)和出现频率(百分比)。最后,我们使用Wilcoxon, Chi2或Fisher精确检验来确定与NH相关的因素是否适用(p < 0.05)。结果:共纳入169例患者,其中男性占60%。胎龄38周(26-42周),早产38%。出生体重为3000 g (545-4950 g), 32%为低出生体重。8例患者住院期间出现高血压(患病率4.7%,CI95% 2.4-9)。高血压的存在与早产(p = 0.0003)、低出生体重(p = 0.01)、产前皮质类固醇治疗(p = 0.002)、脐带置管(p = 0.03)、给予肾毒性药物(p = 0.02)、咖啡因治疗(p = 0.0001)、急性肾损伤(p = 0.02)和颅内高压(p = 0.04)相关。只有1例患者需要抗高血压药物治疗,所有病例的高血压在随访期间得到解决。结论:我们NICU的新生儿高血压患病率为4.7%,所有病例均发生在具有先前确认的高血压相关因素的早产新生儿中。
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[Prevalence of Arterial Hypertension in a neonatal intensive care unit].

Introduction: The prevalence of neonatal hypertension in neonatal intensive care units (NICU) ranges between 3 and 9%. However, there is no current data on Latin America.

Objective: To estimate the prevalence of neonatal hypertension and to assess its association with causes previously related to this condi tion.

Patients and method: cross-sectional study. All patients admitted to the NICU during one year were included, excluding those transferred to the cardiovascular NICU. The following maternal and neonatal variables were registered: maternal arterial hypertension, type of delivery, gestational age, age, sex, birth weight, Apgar score, history of pulmonary maturation with corticosteroids, and umbilical vessel catheterization as well as the reason for admission to the NICU, medications, and complications during hospitalization. Blood pressure was measured with an automated oscillometric device, defining neonatal hypertension according to standards in gestational age. Prevalence was ex pressed as percentage (confidence interval 95%, CI95%). Descriptive data were reported as median (range) and frequency of presentation (percentage). Finally, we used the Wilcoxon, Chi2 o Fisher exact test to identify factors related to NH as applicable (p < 0.05).

Results: 169 patients were in cluded (60% males). Gestational age was 38 weeks (range 26-42 weeks), 38% were preterm. Birth weight was 3000 g (range 545-4950 g) and 32% presented low birth weight. Eight patients presented hypertension during hospitalization (4.7% prevalence, CI95% 2.4-9). The presence of hypertension was associated with prematurity (p = 0.0003), low birth weight (p = 0.01), prenatal corticosteroid treatment (p = 0.002), umbilical catheterization (p = 0.03), administration of ὅ 2 nephrotoxic drugs (p = 0.02), caffeine treatment (p = 0.0001), acute kidney injury (p = 0.02), and intracranial hyper tension (p = 0.04). Only one patient required antihypertensive pharmacologic treatment and in all cases, hypertension was resolved during follow-up.

Conclusion: Prevalence of neonatal hypertension in our NICU was 4.7% and in all cases occurred in preterm newborns with previously recognized factors associated with this condition.

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