Predicting survival in infants with persistent pulmonary hypertension of the newborn

Jonathan M. Davis, Alan R. Spitzer, Christopher Cox, William W. Fox

Research output: Contribution to journalArticlepeer-review

Abstract

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 PaCO2, 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 PaCO2, 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.

Original languageEnglish (US)
Pages (from-to)6-9
Number of pages4
JournalPediatric pulmonology
Volume5
Issue number1
DOIs
StatePublished - 1988
Externally publishedYes

Keywords

  • Hyperventilation therapy
  • clinical scoring system
  • logistic regression analysis
  • risk factors: blood gases, ventilator settings, Apgar score

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pulmonary and Respiratory Medicine

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