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Predicting survival in infants with persistent pulmonary hypertension of the newborn
Author(s) -
Davis Jonathan M.,
Spitzer Alan R.,
Cox Christopher,
Fox William W.
Publication year - 1988
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.1950050103
Subject(s) - medicine , persistent pulmonary hypertension , pulmonary hypertension , pediatrics , intensive care medicine
Since persistent pulmonary hypertension of the newborn (PPHN) often occurs as a life‐threatening illness, it would be advantageous to identify the highest‐risk infants within the first 24 hours of life so that transfer to centers with extracorporeal membrane oxygenation (ECMO) or high‐frequency ventilation can be facilitated. Fifty‐three infants with PPHN were evaluated retrospectively. A multivariate discriminant analysis of risk factors determined that lowest pH, critical Pa CO 2 , highest inspiratory pressure (PI), maximum ventilator rate, and 5‐minute Apgar score were significantly different between the 35 survivors (66%) and the 18 infants (34%) who had died when examined with in the first 24 hours of life. A clinical scoring system was designed based on these five criteria, which predicted outcome accurately in 93% of infants. A logistic regression analysis was performed as a check on these results and found that lowest pH, critical Pa CO 2 , and PI predicted outcome with great accuracy. These results suggest that the use of these scoring systems within the first 24 hours of age may help predict outcome in infants with PPHN.