Comparison between Patients with Persistent Pulmonary Hypertension of Neonates Concomitant with Parenchymal Lung Disease and Idiopathic Persistent Pulmonary Hypertension of Neonates.

Ryu,  In Kyung; Tang,  Chih Lung; Chu,  Shou Yu; Shim,  Gyu Hong; Chey,  Myoung Jae

doi:2017.24.4.157

Neonatal Med > Volume 24(4); 2017 > Article

Original Article

Neonatal Medicine 2017;24(4):157-163.
DOI: https://doi.org/10.5385/nm.2017.24.4.157 Published online November 30, 2017.

Comparison between Patients with Persistent Pulmonary Hypertension of Neonates Concomitant with Parenchymal Lung Disease and Idiopathic Persistent Pulmonary Hypertension of Neonates.

In Kyung Ryu, Chih Lung Tang, Shou Yu Chu, Gyu Hong Shim, Myoung Jae Chey

Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, Korea. peddoc@paik.ac.kr

Abstract

PURPOSE
We aimed to compare the clinical characteristics between neonates with persistent pulmonary hypertension of neonates (PPHN) with parenchymal lung disease (PLD) and those with idiopathic PPHN.
METHODS
We reviewed the medical records of 67 neonates with gestational ages not lesser than 34⁺⁰ weeks who were born at Inje University Sanggye Paik Hospital between June 1, 2005 and December 31, 2016. We excluded 10 neonates who presented with congenital anomalies (n=3), dextrocardia (n=1), triple X syndrome (n=1), death before treatment (n=1), neonatal asphyxia (n=2), and congenital diaphragmatic hernia (n=2). Neonates were categorized into 2 groups—PPHN with PLD (PLD group, those diagnosed with PLD such as respiratory distress syndrome or meconium aspiration syndrome, n=36) and idiopathic PPHN (idiopathic group, n=21). We compared the clinical characteristics, treatment, and laboratory findings between the groups.
RESULTS
The PLD group neonates showed a greater requirement for positive pressure ventilation in the delivery room, higher frequency of meconium staining of amniotic fluid, and greater need for surfactant application than those belonging to the idiopathic group. In contrast, epinephrine use was more common in the idiopathic PPHN group than in the PLD group. The 1-minute Apgar score and pH observed on initial capillary blood gas analysis were lower in the PLD than in the idiopathic group. Severity scores were higher in the idiopathic than in the PLD group 4–7 days after birth.
CONCLUSION
In our study, an overall simplified severity score in the first week after birth was higher in the idiopathic than in the PLD group. These results were particularly statistically significant over postnatal days 4–7.

Key Words: Persistent pulmonary hypertension of the newborn; Neonate; Parenchymal lung disease