Predicting the severity and Outcome of Persistent Pulmonary Hypertension of the Newborn Using New Echocardiography Parameters
Butt MU, Jabri A, Hamade H, et al. Predicting the Severity and Outcome of Persistent Pulmonary Hypertension of the Newborn Using New Echocardiography Parameters [published online ahead of print, 2022 Mar 24]. Curr Probl Cardiol. 2022;101181. doi:10.1016/j.cpcardiol.2022.101181
Objective: To examine echocardiographic (ECHO) parameters correlation with clinical severity indices, Alveolar- arterial gradient (A-a gradient), oxygenation index (OI) and clinical outcomes in newborns with persistent pulmonary hypertension of the newborn (PPHN).
Study design: Retrospective cohort study of 67 subjects, >35 weeks' gestation with the diagnosis of PPHN admitted to the University of Kentucky neonatal intensive care unit (NICU) between September 2014 and December 2016.
Results: High left ventricular end-systolic eccentricity index (EIs) correlates with the overall clinical severity of PPHN as it is associated with higher A-a gradient and OI (p=0.0003 and p<0.0001, respectively). Elevated EIs was also predictive for the use of inhaled nitric oxide (iNO) and extracorporeal membrane oxygenation (ECMO) (p=0.0004 and p<0.0001, respectively). EIs value of >1.38 provides cutoff value as an objective marker for the need for ECMO.
Conclusion: EIs can be used to assess clinical severity and outcomes and should be reported routinely. Further studies are warranted to confirm these results.