دورية أكاديمية
Inhaled Nitric Oxide and Higher Necrotizing Enterocolitis Rates in Congenital Heart Disease Patients.
| العنوان: | Inhaled Nitric Oxide and Higher Necrotizing Enterocolitis Rates in Congenital Heart Disease Patients. |
|---|---|
| المؤلفون: | Menchaca AD; Center for Regenerative Medicine, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio; Department of General Surgery, Indiana University, Indianapolis, Indiana., Style CC; Center for Regenerative Medicine, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio., Kyhl TA; Center for Regenerative Medicine, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio., Chawla M; Center for Regenerative Medicine, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio; The Ohio State University College of Medicine, Columbus, Ohio., Texter KM; Division of Cardiology, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio., Olutoye OO; Center for Regenerative Medicine, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio; Division of Pediatric Surgery, Department of Surgery, The Ohio State University College of Medicine, Columbus, Ohio. Electronic address: oolutoye@nationwidechildrens.org. |
| المصدر: | The Journal of surgical research [J Surg Res] 2023 Aug; Vol. 288, pp. 166-171. Date of Electronic Publication: 2023 Mar 27. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Academic Press Country of Publication: United States NLM ID: 0376340 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1095-8673 (Electronic) Linking ISSN: 00224804 NLM ISO Abbreviation: J Surg Res Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: New York, NY : Academic Press Original Publication: Philadelphia [etc.] |
| مواضيع طبية MeSH: | Enterocolitis, Necrotizing*/epidemiology , Enterocolitis, Necrotizing*/prevention & control , Enterocolitis, Necrotizing*/complications , Heart Defects, Congenital*/complications , Infant, Newborn, Diseases*, Child ; Humans ; Infant, Newborn ; Nitric Oxide ; Vasodilator Agents/therapeutic use ; Lung |
| مستخلص: | Introduction: Certain congenital cardiac lesions are at increased risk for the development of necrotizing enterocolitis (NEC). These patients are often reliant on pulmonary and systemic vasomodulators to maintain adequate perfusion and oxygenation. This study sought to determine whether pulmonary or systemic vasodilator treatment is protective against the development of NEC in this population. Methods: We utilized International Classification of Diseases (ICD) codes to identify high risk congenital cardiac disease patients ≤6 mo of age, cared for at a tertiary children's hospital between January 2011 and January 2021. Cardiac anomalies were stratified into ductal dependent (pulmonary DD-P or systemic DD-S) or independent lesions. The rate of NEC development in those who received vasodilators (inhaled nitric oxide [iNO], pulmonary vasodilators, systemic vasodilators) was compared to controls in a multivariate analysis. Results: Of the 352 patients, who met inclusion criteria, 77.6% had ductal dependent lesions (DD-S 41.9%, DD-P 35.7%), 19.5% received iNO, and 37.5% received other vasodilatory drugs. The overall NEC rate was 15.1%. On univariate analysis, DD-S, iNO use, and systemic vasodilators was associated with a significantly higher risk of NEC, while DD-P was associated with lower NEC risk. On multivariate analysis, only iNO (odds ratio 2.725, confidence interval [1.36-5.44]) and DD-S (odds ratio 2.279, confidence interval [1.02-5.11]) were independent risk factors for NEC. Conclusions: In patients with at-risk congenital cardiac disease lesions, a ductus dependent systemic circulation or iNO treatment is associated with an increased risk of developing NEC. The presence of iNO or DD-S should be utilized as markers of increased risk both in the prevention and workup of suspected NEC. (Copyright © 2023 Elsevier Inc. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Congenital heart disease; Ductus arteriosus; Inhaled nitric oxide; Necrotizing enterocolitis; Vasodilators |
| المشرفين على المادة: | 31C4KY9ESH (Nitric Oxide) 0 (Vasodilator Agents) |
| تواريخ الأحداث: | Date Created: 20230329 Date Completed: 20230515 Latest Revision: 20230531 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1016/j.jss.2023.02.020 |
| PMID: | 36989832 |
| قاعدة البيانات: | MEDLINE |
Full Text via ClinicalKey 
Full Text Finder | تدمد: | 1095-8673 |
|---|---|
| DOI: | 10.1016/j.jss.2023.02.020 |