Ourania Kaltsogianni, Ravindra Bhat, Anne Greenough, Theodore Dassios
{"title":"新生儿的心动过速和持续性肺动脉高压。","authors":"Ourania Kaltsogianni, Ravindra Bhat, Anne Greenough, Theodore Dassios","doi":"10.3389/fped.2025.1607907","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>It is not known whether tachycardia in persistent pulmonary hypertension of the newborn (PPHN) is due to the use of inotropic agents or is a pathophysiological process related to the disease <i>per se</i>. In this study, we aim to test the hypothesis that tachycardia in PPHN would be related to non-invasive indices of PPHN.</p><p><strong>Methods: </strong>This is a retrospective study of ventilated infants with echocardiographically confirmed PPHN at the Neonatal Intensive Care Unit of King's College Hospital NHS Foundation Trust. The difference of the partial pressure of arterial (PaCO<sub>2</sub>) to end-tidal CO<sub>2</sub> (EtCO<sub>2</sub>) or PaCO<sub>2</sub>-EtCO<sub>2</sub> gradient was calculated as an index of PPHN severity and was related to the level of tachycardia at acute PPHN and after the resolution of PPHN (pre-extubation).</p><p><strong>Results: </strong>Fifteen infants with PPHN were studied, whose median (interquartile range, IQR) gestational age was 35.7 (34.1-40.3) weeks and birth weight was 2.95 (2.17-3.20) kg. It was found that the median (IQR) heart rate was higher during acute PPHN [158 (122-169) bpm] compared with that during pre-extubation [119 (111-136) bpm, <i>p</i> = 0.016]. The difference in the heart rate at acute illness and pre-extubation was significantly related to the difference in the PaCO<sub>2</sub>-EtCO<sub>2</sub> gradient (correlation coefficient = 0.732, <i>p</i> = 0.016).</p><p><strong>Conclusions: </strong>There was a significant association between tachycardia and the severity of PPHN in ventilated infants, possibly describing that tachycardia is the result of PPHN <i>per se</i>, as well as the effect of inotropes.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1607907"},"PeriodicalIF":2.1000,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12162909/pdf/","citationCount":"0","resultStr":"{\"title\":\"Tachycardia and persistent pulmonary hypertension of the newborn.\",\"authors\":\"Ourania Kaltsogianni, Ravindra Bhat, Anne Greenough, Theodore Dassios\",\"doi\":\"10.3389/fped.2025.1607907\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>It is not known whether tachycardia in persistent pulmonary hypertension of the newborn (PPHN) is due to the use of inotropic agents or is a pathophysiological process related to the disease <i>per se</i>. In this study, we aim to test the hypothesis that tachycardia in PPHN would be related to non-invasive indices of PPHN.</p><p><strong>Methods: </strong>This is a retrospective study of ventilated infants with echocardiographically confirmed PPHN at the Neonatal Intensive Care Unit of King's College Hospital NHS Foundation Trust. The difference of the partial pressure of arterial (PaCO<sub>2</sub>) to end-tidal CO<sub>2</sub> (EtCO<sub>2</sub>) or PaCO<sub>2</sub>-EtCO<sub>2</sub> gradient was calculated as an index of PPHN severity and was related to the level of tachycardia at acute PPHN and after the resolution of PPHN (pre-extubation).</p><p><strong>Results: </strong>Fifteen infants with PPHN were studied, whose median (interquartile range, IQR) gestational age was 35.7 (34.1-40.3) weeks and birth weight was 2.95 (2.17-3.20) kg. It was found that the median (IQR) heart rate was higher during acute PPHN [158 (122-169) bpm] compared with that during pre-extubation [119 (111-136) bpm, <i>p</i> = 0.016]. The difference in the heart rate at acute illness and pre-extubation was significantly related to the difference in the PaCO<sub>2</sub>-EtCO<sub>2</sub> gradient (correlation coefficient = 0.732, <i>p</i> = 0.016).</p><p><strong>Conclusions: </strong>There was a significant association between tachycardia and the severity of PPHN in ventilated infants, possibly describing that tachycardia is the result of PPHN <i>per se</i>, as well as the effect of inotropes.</p>\",\"PeriodicalId\":12637,\"journal\":{\"name\":\"Frontiers in Pediatrics\",\"volume\":\"13 \",\"pages\":\"1607907\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2025-05-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12162909/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in Pediatrics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3389/fped.2025.1607907\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Pediatrics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fped.2025.1607907","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}
Tachycardia and persistent pulmonary hypertension of the newborn.
Background: It is not known whether tachycardia in persistent pulmonary hypertension of the newborn (PPHN) is due to the use of inotropic agents or is a pathophysiological process related to the disease per se. In this study, we aim to test the hypothesis that tachycardia in PPHN would be related to non-invasive indices of PPHN.
Methods: This is a retrospective study of ventilated infants with echocardiographically confirmed PPHN at the Neonatal Intensive Care Unit of King's College Hospital NHS Foundation Trust. The difference of the partial pressure of arterial (PaCO2) to end-tidal CO2 (EtCO2) or PaCO2-EtCO2 gradient was calculated as an index of PPHN severity and was related to the level of tachycardia at acute PPHN and after the resolution of PPHN (pre-extubation).
Results: Fifteen infants with PPHN were studied, whose median (interquartile range, IQR) gestational age was 35.7 (34.1-40.3) weeks and birth weight was 2.95 (2.17-3.20) kg. It was found that the median (IQR) heart rate was higher during acute PPHN [158 (122-169) bpm] compared with that during pre-extubation [119 (111-136) bpm, p = 0.016]. The difference in the heart rate at acute illness and pre-extubation was significantly related to the difference in the PaCO2-EtCO2 gradient (correlation coefficient = 0.732, p = 0.016).
Conclusions: There was a significant association between tachycardia and the severity of PPHN in ventilated infants, possibly describing that tachycardia is the result of PPHN per se, as well as the effect of inotropes.
期刊介绍：
Frontiers in Pediatrics (Impact Factor 2.33) publishes rigorously peer-reviewed research broadly across the field, from basic to clinical research that meets ongoing challenges in pediatric patient care and child health. Field Chief Editors Arjan Te Pas at Leiden University and Michael L. Moritz at the Children''s Hospital of Pittsburgh are supported by an outstanding Editorial Board of international experts. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.
Frontiers in Pediatrics also features Research Topics, Frontiers special theme-focused issues managed by Guest Associate Editors, addressing important areas in pediatrics. In this fashion, Frontiers serves as an outlet to publish the broadest aspects of pediatrics in both basic and clinical research, including high-quality reviews, case reports, editorials and commentaries related to all aspects of pediatrics.
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