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循环Endothelin-1的增加是ECMO使用和新生儿与先天性隔膜的死亡的风险因素:一个前性观察研究

Lotte Lemloh¹, Aster de Vadder¹, Tamene Melaku¹

¹Department of Neonatology and Pediatric Intensive Care, Children's Hospital, University of Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.

Respiratory research

|March 22, 2025

概括

患有先天性隔膜 (CDH) 的新生儿中的Endothelin-1 (ET-1) 水平升高预测需要ECMO和死亡率. 监测ET-1可以指导早期干预,以获得CDH患者更好的结果.

科学领域:

新生儿科学新生儿科学
儿科手术儿科手术
心血管研究研究心血管研究

背景情况:

内膜-1 (ET-1) 是一种血管活性,与先天性隔膜 (CDH) 的新生儿的不良结果有关.
在CDH新生儿中,ET-1水平与临床结果之间的确切关系需要进一步阐明.

研究的目的:

研究CDH新生儿从出生到产后48小时内ET-1水平的时间变化 (动力学).
评估ET-1水平与临床并发症,体外膜氧化 (ECMO) 要求和CDH新生儿死亡率之间的关联.

主要方法:

一项前性单中心研究包括107名CDH新生儿 (2014-2022年).
血液样本用于ET-1测量是在出生时,出生后6小时和48小时收集的.
使用统计分析,包括ROC曲线分析和多变量后勤回归,来评估ET-1对ECMO和死亡率的预测值.

主要成果:

产后0和48小时ET-1水平较高与ECMO需求 (p=0.028和p<0.001) 和死亡率 (p=0.016和p<0.001) 的增加显著相关.
高ET-1组的新生儿使用ECMO的比率 (63.2%) 和死亡率 (42.1%) 与低ET-1组 (15.4%和0%) 相比显著更高.
升高的ET-1水平与严重的肺高血压和双心脏功能障碍有关.

结论:

在CDH新生儿生命前48小时内ET-1水平升高是增加ECMO需求和死亡率的强有力的预测因素.
ET-1显示出作为预测生物标志物的潜力,用于识别CDH新生儿,这些新生儿面临着不良结果的高风险.
这些发现可能会为CDH管理的治疗策略和干预措施提供信息.

关键词:

生产性腹膜 Hernia 是一种先天性腹膜.输内甲林-1-1是什么身体外膜氧化器的氧化肺高血压是因为肺高血压.

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