The Value of Right Heart Function Monitoring in Assessing the Prognosis of Acute Respiratory Distress Syndrome in Neonates
Objective Objective To investigate the value of right heart function monitoring in assess-ing the prognosis of acute respiratory distress syndrome(ARDS)in neonates.Methods All 112 neo-nates with ARDS were selected to be treated with conventional mechanical ventilation and basic medica-tion,and were categorized into good prognosis and poor prognosis groups according to their 28-day prog-nosis.A fully automatic biochemical analyzer was used to detect neonatal blood and procalcitonin(PCT),C-reactive protein(CRP),and plasma N-terminal brain natriuretic peptide precursor(NT-proBNP)levels.Neonatal cardiac function indices[cardiac index(CI),right ventricular work index(RV-Tei)and right ventricular ejection fraction(RVEF)]were detected using echocardiography.Clini-cal data of neonates were collected,logistic multifactorial regression analysis was used to clarify the risk factors affecting the prognosis of neonatal ARDS,and the predictive value of right heart function monito-ring on the prognosis of neonatal ARDS was assessed by plotting the subject operating characteristic(ROC)curve.Results Of the 112 neonates with ARDS,81 had a favorable prognosis and 31 had a poor prognosis.Gestational age,length of hospitalization,oxygenation index(OI),and globulin,albu-min,and PCT levels were higher in the good prognosis group than those in the poor prognosis group(P<0.05).However,the proportion of PS use≥3,the duration of mechanical ventilation,CRP,RV-Tei,NT-proBNP and RVEF were lower than those in the poor prognosis group(P<0.05).The results of lo-gistic multifactorial regression analysis showed that RV-Tei(P=0.011,OR=3.836,95%CI:1.363-10.797)and NT-proBNP(P=0.001,OR=2.322,95%CI:1.411-3.820)were the independent risk factors affecting the prognosis of neonatal ARDS.After ROC curve analysis,the sensitivity,accuracy and area under the curve(AUC)of RV-Tei combined with NT-proBNP for prognosis of neonatal ARDS were 92.60%,91.54%and 0.822,respectively.Conclusion RV-Tei and NT-proBNP are associated with the prognosis of neonatal ARDS,and the prognostic value of the two combined evaluation of ARDS neo-nates is high.
acute respiratory distress syndromenewbornsright heart functionprognosisassess value
万方数据
维普
