Preterm Ve Term İnfantlarda İnhale Nitrik Oksit Sonuçları: Üçüncü Düzey Yenidoğan Yoğun Bakım Ünıtesındeki Dört Yıllık Deneyim

Öz

GİRİŞ ve AMAÇ: Bu çalışmada pulmoner hipertansiyon (PH) kliniği ile karakterize olan preterm ve term infantların, inhale nitrik oksit (INO) tedavisine yanıtlarındaki etkinliğin değerlendirilmesi amaçlanmıştır. YÖNTEM ve GEREÇLER: Çalışma kohortu 2015-2019 yılları arasında INO tedavisi alan hastalardan oluşmuştur, hastalar gestasyon haftaları ve PH tanısının zamanına göre sınıflandırılmıştır. BULGULAR: Çalışmaya toplamda 56 vaka dahil edilmiştir. iNO öncesi ve iNO sonrası ortalama hava yolu basınç değerleri ve oksijenasyon indeksi preterm infantların grubunda anlamlı düzeyde yüksek bulundu (p < 0.05). Erken PH tanısı alan grupta ortalama gestasyon haftası (GH) ve doğum ağırlığı (DA) daha yüksek bulundu. INO tedavisine yanıt veren grupta GH'ları ve DA'nın belirgin yüksek oldugu izlendi (p < 0.05). INO tedavisine yanıt alınamayan hastaların genellikle tanıları term bebeklerde diafragma hernisi iken pretermlerde sepsisdi. TARTIŞMA ve SONUÇ: Term infantlarda İNO tedavisine daha iyi yanıt alınmakla beraber pretermlerde de İNO tedavisine erken başlanması ile daha iyi yanıt alınabilir.

Anahtar Kelimeler

• inhale nitrik oksit,preterm,pulmoner hipertansiyon

Outcomes of Inhaled Nitric Oxide in Preterm and Term Infants: A Four-Year Experience in a Tertiary Neonatal Unit

Öz

INTRODUCTION: This study aimed at assessing the data of term and preterm neonates with pulmonary hypertension (PH) to characterise patients and the effectiveness of inhaled nitric oxide (iNO). MATERIALS and METHODS: The study cohort treated with iNO between 2015 and 2019 was categorized into two groups according to the gestational age (GA) and timing of PH. RESULTS: Overall 56 neonates were enrolled. Pre-iNO, post-iNO mean airway pressure values, and oxygenation index were significantly higher in the preterm group (p < 0.05). Mean GA and birth weight of the infants who had early PH diagnosis were higher. Positive responders were more likely to have higher GA as well as higher birth weight (p < 0.05). Non-responders were mostly diagnosed with diaphragmatic hernia in term infants and with sepsis in preterm infants CONCLUSIONS: Despite term infants have higher positive response rate to treatment, initiating early treatment will increase the rate of positive response in preterm infants.

Anahtar Kelimeler

• inhale nitric oxide,preterm,pulmonary hypertension

Kaynakça

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