Risk factors for cardiopulmonary dysfunction after ligation of hemodynamically significant patent ductus arteriosus in preterm infants.
10.7499/j.issn.1008-8830.2411050
- Author:
Chong-Chong LIU
1
;
Yong LIU
1
;
Yi ZHANG
1
;
Dai-Cheng HAN
1
;
Rui-Jing HE
;
Shi-Wen XIA
1
Author Information
1. Department of Neonatology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430070, China com.
- Publication Type:Journal Article
- Keywords:
Cardiopulmonary dysfunction;
Patent ductus arteriosus;
Preterm infant;
Risk factor;
Surgical ligation
- MeSH:
Humans;
Ductus Arteriosus, Patent/physiopathology*;
Risk Factors;
Female;
Infant, Newborn;
Male;
Retrospective Studies;
Infant, Premature;
Ligation/adverse effects*;
Hemodynamics;
Postoperative Complications/etiology*;
Logistic Models;
Lung Diseases/etiology*
- From:
Chinese Journal of Contemporary Pediatrics
2025;27(4):425-431
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVES:To investigate the risk factors for the occurrence of cardiopulmonary dysfunction following ligation of hemodynamically significant patent ductus arteriosus (hsPDA) in preterm infants.
METHODS:A retrospective collection of clinical data was conducted on preterm infants with a gestational age of <34 weeks who were admitted to the Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology from January 2018 to August 2024. These infants underwent hsPDA ligation after 1-2 courses of failed ibuprofen treatment. Based on the occurrence of blood pressure changes and oxygenation or ventilation failure postoperatively, the infants were divided into a cardiopulmonary dysfunction group (19 cases) and a non-cardiopulmonary dysfunction group (40 cases). Binary logistic regression analysis was performed to explore risk factors for postoperative cardiopulmonary dysfunction.
RESULTS:Binary logistic regression analysis indicated that a faster average weight gain rate preoperatively and low levels of free triiodothyronine (FT3) within one week before surgery were risk factors for cardiopulmonary dysfunction following hsPDA ligation (P<0.05). Receiver operating characteristic curve analysis showed that an average weight gain rate >11.45 g/(kg·d) and FT3 levels <2.785 pmol/L within one week before surgery had predictive value for postoperative cardiopulmonary dysfunction (P<0.05). The combination of these two indicators provided the highest predictive value (P<0.05), with an area under the curve of 0.825, a sensitivity of 79%, and a specificity of 75%.
CONCLUSIONS:An average weight gain rate exceeding 11.45 g/(kg·d) and FT3 levels below 2.785 pmol/L within one week before surgery are risk factors affecting cardiopulmonary function after hsPDA ligation. Preoperative assessment and intervention should be strengthened to reduce the risk of postoperative complications.
