Table 1.
Characteristics of the population of the study, clinical, paraclinical informations and management of the PPHN.
| N = 55 | |
|---|---|
| Pre- and per-partum characteristics | |
| Outborn birtha, n (%) | 45 (81.8%) |
| Rupture of membranes >12 h, n (%) | 6 (10.9%) |
| Meconium amniotic fluid, n (%) | 25 (45.5%) |
| Perinatal cardiac arrhythmias, n (%) | 30 (54.5%) |
| Maternal fever, n (%) | 14 (25.5%) |
| Chorioamnionitis, n (%) | 2 (3.6%) |
| Neonatal characteristics | |
| Prematurityb, n (%) | 10 (18.2%) |
| Post-term pregnancyc, n (%) | 4 (7.3%) |
| Neonatal resuscitation in the delivery roomd, n (%) | 47 (85.5%) |
| Lactate Umbilical-cord blood gas (mmol/L) (n = 48), mean (±SD) | 6.7 (3.8) |
| Clinical and paraclinical data | |
| Haemodynamic data | |
| Minimal Mean Blood Pressure (MBP, mmHg), mean (SD) | 30.9 (5.8) |
| Hypotension cumulative scoree, median [IQR] | 2 [0; 5] |
| Haemodynamic shock, n (%) | 37 (67.3%) |
| Oxygenation and ventilation data | |
| Minimal pre-ductal saturation (%), mean (SD) | 79 (12) |
| Desaturation cumulative scoree, median [IQR] | 4 [1; 10] |
| Ventilation parameters: total duration of maximal FiO2f, median [IQR] | 14 [4; 66] |
| Chest radiograph with hyperlucency or without opacities, n (%) | 52 (94.5%) |
| Neurologic data | |
| Pathological Sarnat score (2 or 3), n (%) | 4 (7.3%) |
| Intensive care management data | |
| Total length of hospital stay (days), median [IQR] | 17 [11.5; 30.5] |
| Ventilation | |
| Delay of intubation from birth (minutes), median [IQR] | 120 [22.5; 140.0] |
| Usage of high frequency oscillation, n (%) | 29 (53.7%) |
| Surfactant instillation (one ou two doses), n (%) | 33 (60.0%) |
| Haemodynamic | |
| Fluid resuscitation, n (%) | 33 (60.0%) |
| Total duration of inotropic-vasopressive drugs (days), mean (SD) | 3.2 (2.9) |
| VISg, median [IQR] | 20 [10; 90] |
| Sedation and curarisation | |
| Duration of sedation (days), median [IQR] | 4 [3; 8] |
| Curarisation, n (%) | 26 (47.3%) |
| Therapeutic data specific to PPHN | |
| Initiation of iNO (delay from birth, in hours), median [IQR] | 11 [6; 25] |
| Maximal dose of iNO (ppm), mean (SD) | 16.3 (6.1) |
| Prostaglandin E1 (Alprostadil), n (%) | 9 (16.4%) |
| Corticosteroids, n (%) | 27 (49.1%) |
| Complications | |
| Early onset neonatal infectionh, n (%) | 7 (12.7%) |
| Secondary infectioni, n (%) | 4 (7.3%) |
| Blood transfusion, n (%) | 21 (38.2%) |
| Methemoglobinemia (>3%), n (%) | 1 (1.8%) |
| Prolonged nutritional supportj, n (%) | 25 (45.5%) |
Outborn birth (outside our main hospital in Toulouse).
Prematurity: birth between 340/6 and 366/6 amenorrhea weeks (AW).
Post-term: birth after 42 AW (≥420/6 AW).
Neonatal resuscitation in the delivery room means at least mask ventilation and included chest compression if necessary.
Hypotension or desaturation cumulative scores: Recording once per hour of one or more desaturation (≤90%) or arterial hypotension (MBP ≤35 mmHg).
Total duration of maximal FiO2 corresponding to the number of hours with Fraction of inspired oxygen ≥90%.
VIS: vasoactive-inotropic score, ≥20 high score and <20 low score.
Early onset infection was defined as occurring within the first 72 h of life.
Secondary infection was defined as a sepsis acquired later than the first 72 h of life.
Prolonged nutritional support by parenteral nutrition or nasogastric tube ≥8 days.