Faith Zhu, Daniel Ibarra Rios, Sebastien Joye, Michelle Baczynski, Danielle Rios, Regan E. Giesinger, Patrick J. McNamara, Amish Jain
Mount Sinai Hospital and University of Toronto. Hospital Infantil de México Federico Gómez. Lausanne University Hospital. University of Iowa.
Canada, Mexico, Switzerland and United States
Journal of Perinatology
J Perinatol 2023
DOI: 10.1038/s41372-023-01742-0
Abstract
Objective: Using targeted neonatal echocardiography (TNE) to examine cardiopulmonary physiological impact of diuretics in preterm infants with chronic pulmonary hypertension (cPH).
Study design: Retrospective study comparing TNE indices pre- and ≤2 weeks (post) of initiating diuretic therapy in infants born <32 weeks gestational age with cPH.
Results: Twenty-seven neonates with mean gestational age, birthweight and interval between pre-post diuretic TNE of 27.0 ± 2.8 weeks, 859 ± 294 grams, and 7.8 ± 3.0 days respectively were studied. Diuretics was associated with improvement in pulmonary vascular resistance [pulmonary artery acceleration time (PAAT); 34.27(9.76) vs. 40.24(11.10)ms, p = 0.01), right ventricular (RV) ejection time:PAAT ratio [5.92(1.66) vs. 4.83(1.14), p < 0.01)], RV fractional area change [41.6(9.8) vs. 46.4(6.5%), p = 0.03)] and left ventricular myocardial performance index [0.55(0.09) vs. 0.41(0.23), p < 0.01)]. Post-treatment, frequency of bidirectional/right-to-left inter-atrial shunts decreased significantly (24% vs. 4%, p = 0.05).
Conclusion: Primary diuretic treatment in neonates with cPH may result in improvement in PVR, RV and LV function and compliance.
Category
Class III. Pulmonary Hypertension Associated with Lung Disease
Medical Therapy. Efficacy or Lack of Efficacy
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Filed (PHiled). Greater than 1-2 years since publication
Article Access
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