肺血管扩张剂在美国儿童医院早产儿中的应用

IF 2.4 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Journal of Perinatology Pub Date : 2025-05-02 DOI:10.1038/s41372-025-02309-x

Tomas F Vega, Matthew Huber, Erik A Jensen, Catherine M Avitabile, Scott A Lorch, Kathleen A Gibbs, Michael L O'Byrne, David B Frank, Nicolas A Bamat

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引用次数: 0

摘要

目的：描述常见的肺血管扩张剂（PV），暴露时间，及其在极早产儿（VP）中使用的相关特征。研究设计：对2011-2021年从美国儿童医院出院的VP婴儿进行观察性研究。确定住院期间的PV暴露，并通过多变量模型确定与暴露相关的特征。结果：37,428名婴儿中，6.3%接受了PV。早期吸入一氧化氮（iNO）和晚期吸入西地那非最为常见。早期暴露与较低胎龄相关，aOR: 9.2(7.3-11.7)， 22-25周对29-31周)，胎龄较小（SGA）， 2.3（2.0-2.7）。晚期暴露与支气管肺发育不良（BPD）等级相关，26.2(16.8-40.9)，3级（与无BPD）和早期PV暴露相关，3.7（2.9-4.8）。结论：尽管证据有限，但早期iNO和晚期西地那非可用于VP婴儿。纳入极早产儿和SGA婴儿的前瞻性早期研究，以及纳入早期PV暴露和高度BPD婴儿的晚期研究，将针对目前的证据空白。

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Pulmonary vasodilator use in very preterm infants in United States children's hospitals.

Objectives: To describe common pulmonary vasodilators (PV), exposure timing, and characteristics associated with their use in very preterm (VP) infants.

Study design: Observational study of VP infants discharged from U.S. children's hospitals (2011-2021). PV exposures during hospitalization were identified, and multivariable modeling determined characteristics associated with exposure.

Results: Among 37,428 infants, 6.3% received PV. Early inhaled nitric oxide (iNO) and late sildenafil were most common. Early exposure was associated with lower gestational age, aOR: 9.2 (7.3-11.7), 22-25 vs. 29-31 weeks) and small for gestational age (SGA), 2.3 (2.0-2.7). Late exposure was associated with bronchopulmonary dysplasia (BPD) grade, 26.2 (16.8-40.9), grade 3 vs. no BPD) and early PV exposure, 3.7 (2.9-4.8).

Conclusions: Early iNO and late sildenafil are used in VP infants despite limited evidence. Prospective early studies enrolling extremely preterm and SGA infants and late studies enrolling infants with early PV exposure and high-grade BPD would target current evidence gaps.

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来源期刊

Journal of Perinatology 医学-妇产科学

CiteScore

5.40

自引率

6.90%

发文量

284

审稿时长

3-8 weeks

期刊介绍： The Journal of Perinatology provides members of the perinatal/neonatal healthcare team with original information pertinent to improving maternal/fetal and neonatal care. We publish peer-reviewed clinical research articles, state-of-the art reviews, comments, quality improvement reports, and letters to the editor. Articles published in the Journal of Perinatology embrace the full scope of the specialty, including clinical, professional, political, administrative and educational aspects. The Journal also explores legal and ethical issues, neonatal technology and product development. The Journal’s audience includes all those that participate in perinatal/neonatal care, including, but not limited to neonatologists, perinatologists, perinatal epidemiologists, pediatricians and pediatric subspecialists, surgeons, neonatal and perinatal nurses, respiratory therapists, pharmacists, social workers, dieticians, speech and hearing experts, other allied health professionals, as well as subspecialists who participate in patient care including radiologists, laboratory medicine and pathologists.