Child Health Status, Neurodevelopmental Outcome, and Parental Satisfaction in a Randomized, Controlled Trial of Nitric Oxide for Persistent Pulmonary Hypertension of the Newborn

Ellington, Marty; O’Reilly, Deirdre; Allred, Elizabeth N.; McCormick, Marie C.; Wessel, David; Kourembanas, Stella

doi:10.1542/peds.107.6.1351

Cited by 31 publications

(23 citation statements)

References 33 publications

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“…34 He concluded that, overall, INO was effective in treating PPHN in MAS. He observed that all the four studies under review [35][36][37][38] reported significant medical and neurodevelopmental sequelae. Ichiba et al 39 later reported that the outcome of INO-treated infants depended on their response to treatment.…”

Section: Outcome Of Infants Following Ecmo Treatment In the 1980smentioning

confidence: 99%

“…All the four reports [35][36][37][38] following the treatment with INO claimed improvement in the survival but identified significant neurodevelopment morbidity among the survivors. The NICHD collaborative reports 36,40 on infants treated with INO who were followed up at 24 months showed no difference in disabilities between the control and the INO-treated groups.…”

Section: Outcome Of Infants Following Ecmo Treatment In the 1980smentioning

confidence: 99%

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Neurodevelopmental outcome of infants with meconium aspiration syndrome: report of a study and literature review

Beligere

Rao

2008

J Perinatol

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There is a paucity of information on long-term outcome of infants who have suffered from meconium aspiration syndrome (MAS) in the neonatal period. We analyzed long-term developmental outcome data of 35 infants who were admitted to the neonatal intensive care unit (NICU) at the University of Illinois Hospital at Chicago (UICMC) with a diagnosis of MAS, and we reviewed the literature pertinent to the subject. The objective of the study was to assess the neurodevelopment status of MAS infants and compare the possible effects of different variables that are known to affect the later developmental outcome. The variables included mode of delivery, APGAR score, cord pH, mode of treatment, and neurological findings during the course of NICU. The infants were enrolled in the developmental followup program (DFUP) after discharge from the nursery for assessment of long-term developmental status and neurodevelopmental outcome. In order to assess the impact of the treatment on long-term outcome and compare our findings with previously published reports, we also reviewed the previously published literature on neurodevelopment outcome of infants treated for MAS (with different modalities) during the last three decades. Total of 35 infants with a diagnosis of MAS admitted to the NICU at UICMC were followed in the DFUP clinic for 3 years during January 1999 to September 2001. The medical records of these infants were reviewed for the mode of delivery, APGAR score, birth weight (BW), gestational age, mode of treatment during the neonatal period, and neurodevelopment status. 19/35 (54%) infants were delivered vaginally, 16/35 (46%) by cesarean section (C-section). All were treated in the delivery room using the standard resuscitation protocol. Following initial resuscitation, all except three required intubation and ventilation for varying duration. One infant required inhaled nitric oxide therapy, and two required extracorporeal membrane oxygenation treatment. Subsequent to discharge, the infants were evaluated in the clinic at 2 months of age, and then every 4 months up to 3 years. The developmental assessment of mental development index (MDI), psychomotor development index (PDI), and behavior rating scale (BRS) were obtained using the Bayley II infant motor scale, and neurodevelopment evaluation was performed using the Amiel-Tison technique. Speech evaluation was performed in infants >18 months using the Rossetti Infant-Toddler language scale. Infants were considered normal when MDI and PDI scores were >85 to 110; mildly delayed when scores were >70 to 84; and severely delayed if the scores were <69. In addition, neurological evaluation also confirmed the disability. The report is based on the final analysis of 29 infants. Data of six infants were not included in the final analysis because of incomplete information. The mean BW of the infants was 3269±671 g; mean gestational age was 39.5±3.1 weeks. The median APGAR score at 1 0 was 4, and at 5 0 was 6. Out of 29, 11 (38%) infants were normal. Out of 29, 2 infants (7%) had cere...

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Section: Outcome Of Infants Following Ecmo Treatment In the 1980smentioning

confidence: 99%

Section: Outcome Of Infants Following Ecmo Treatment In the 1980smentioning

confidence: 99%

Neurodevelopmental outcome of infants with meconium aspiration syndrome: report of a study and literature review

Beligere

Rao

2008

J Perinatol

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“…Group studies of children with PPHN report 0 -50% of survivors have hearing loss [Sell et al, 1985;Hendricks-Munoz and Walton, 1988;Marron et al, 1992;Kawashiro et al, 1996, Ellington et al, 2001 In a study by Kawashiro et al [1996] eight of 10 children with hearing loss associated with PPHN or ECMO had a late onset hearing loss.…”

Section: Persistent Pulmonary Hypertension and Extracorporeal Membranmentioning

confidence: 99%

Nongenetic causes of hearing loss

Roizen

2003

Ment. Retard. Dev. Disabil. Res. Rev.

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Nongenetic as well as genetic etiologies must be explored in the child with identified hearing loss. Graduates of the neonatal intensive care unit are at increased risk for developing hearing loss due to hypoxia, hyperbilirubinemia, very low birth weight, and ototoxic medications. Although meningitis has decreased in frequency, it is still a risk factor for hearing loss. Cytomegalovirus remains the most common congenital infection and a relatively common etiology of hearing loss, which can be progressive. Preventable causes of hearing loss include those caused by head trauma, noise, and ototoxic medications. Identification of the etiology of hearing loss can facilitate the development of a treatment and management plan.

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“…Hastaların uzun süreli izlemlerine bakıldığında gerek modern tedavi yöntemlerinden önce gerekse günümüzde nörogelişimsel sorunların ve sensorinöral işitme kaybının önde gelen sorunlardan olduğu görülmektedir. Bir yıllık izlemde 133 bebekte major nörolojik bozukluk %13, kognitif bozukluk %30 ve işitme kaybı %19 olarak belirtilmiş, başka bir çalış-mada da 60 bebek 1-4 yıl izlenmiş ve nörolojik sekel %15, davranış bozukluğu %26 ve işitme kaybı %7 oranında bildirilmiştir (20,21). Sonuç PPHN yüksek mortalite ve morbidite ile seyreden bir hastalık olmasına karşın İ-NO ve ECMO hastalığın seyrini anlamlı ölçüde değiştirmiştir.…”

Section: Yenidoğanın Persistan Pulmoner Hipertansiyonu (Yd-pph)unclassified

Pediatric pulmonary hypertension and pulmonary arterial hypertension secondary to congenital heart diseases

Olguntürk¹

2010

Anadolu Kardiyol Derg

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Causes of pulmonary arterial hypertension (PAH) are similar in adults and children. The main difference is that PAH secondary to congenital heart diseases, is the predominant cause in pediatric patients. Persistent pulmonary hypertension of the newborn shows completely different clinical course and pathophysiological mechanisms. It is usually seen in full term babies with a high morbidity and mortality rate. Improved prognosis has been reported with inhaled nitric oxide (NO) and extracorporeal membrane oxygenation therapy in babies hospitalized in well equipped and experienced newborn centers. Primary pulmonary hypertension and familial pulmonary hypertension are rare in pediatric age group because the diagnosis is initially made in adolescence. The incidence of PAH secondary to congenital heart disease is estimated as 1.6 -12.5 case/million/year. Eisenmenger syndrome is diagnosed in 1% of patients with PAH. Patients with left to right shunts are the main group who develop pulmonary vascular disease if not treated in the early infancy. Some cyanotic congenital heart diseases are also the causes of PAH. The best treatment of patients at risk for the development of pulmonary vascular disease is prevention by early surgical elimination of defects or repairing the anatomy. Treatment options with vasodilating agents like NO, prostaglandin analogs, phosphodiesterase -5 inhibitors and endothelin receptor antagonists are used to improve survival and quality of life. Heart lung or bilateral lung transplantation is the only surgical option for many of these patients. Results of national and international registries will bring valuable epidemiological and prognostic perspectives to pediatric PAH. (Anadolu Kardiyol Derg 2010; 10: Suppl 1; 50-6) Key words: Child, pulmonary hypertension, congenital heart disease ÖZET Çocuklarda görülen pulmoner arteriyel hipertansiyon (PAH) tipleri erişkinlerde görülenlerle benzerlik göstermekle birlikte daha çok doğumsal kalp hastalıklarına (DKH) ikincil olarak gelişen PAH tipi sıktır. Yenidoğan persistan pulmoner hipertansiyonu (YD-PPH) ise tamamen farklı bir mekanizma ve gidiş gösterir. YD-PPH daha çok gebelik süresini tamamlamış yenidoğanların hastalığıdır. Yüksek morbidite ve mortalite ile seyreder. Son yıllar-da tedavide inhale nitrik oksit (NO) ve ekstrakorporeal membran oksijenasyonun kullanılması, deneyimli merkez sayısının artması hastalığın seyrini önemli ölçüde değiştirmiştir. Nadir görülen primer ve ailevi PAH iyi bir anamnez ve fizik inceleme ile kuşkulanılarak tanı konulabilen ancak ilerlemiş olgularda semptomatik olan PAH türleridir. Doğumsal kalp hastalıklarına bağlı PAH sıklığı 1.6-12.5 olgu/milyon/yıl olarak bildirilmiştir. PAH'lı hastaların %1'inde Eisenmenger sendromu tanımlanmıştır. Çocuklarda soldan sağa şantlı DKH'ları pulmoner arteriyel hipertansiyonun başlıca nedenidir. DKH olan PAH'lı çocukların erken cerrahi ile tedavi edilmeleri pulmoner vasküler hastalığın önlenmesi için gereklidir. Bu hastalarda yaşam süresi ve kalitesini artırmak amacı ile vazodilatör ilaç teda...

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Child Health Status, Neurodevelopmental Outcome, and Parental Satisfaction in a Randomized, Controlled Trial of Nitric Oxide for Persistent Pulmonary Hypertension of the Newborn

Cited by 31 publications

References 33 publications

Neurodevelopmental outcome of infants with meconium aspiration syndrome: report of a study and literature review

Neurodevelopmental outcome of infants with meconium aspiration syndrome: report of a study and literature review

Nongenetic causes of hearing loss

Pediatric pulmonary hypertension and pulmonary arterial hypertension secondary to congenital heart diseases

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