AI Article Synopsis
- The study aimed to identify distinguishing factors between left heart obstruction (LHO) and other severe illnesses in neonates, which is crucial for effective clinical management.* -
- Conducted as a retrospective cohort study over two decades, it included 273 neonates suspected of having LHO, finding that 240 had confirmed cases and achieved a diagnostic accuracy of 74.4%.* -
- The results highlighted that hepatomegaly was significantly linked to LHO, suggesting that a low threshold for using prostaglandin E in suspected cases is necessary, especially since it did not negatively impact other health metrics.*
Article Abstract
Aim: Differentiating left heart obstruction (LHO) from other severe illness in the neonatal period is challenging, and important for guiding clinical management. The aim of this study was to identify factors distinguishing LHO from non-LHO in neonates.
Methods: A retrospective, cohort study of neonates referred to the Newborn and Paediatric Emergency Transport Service, New South Wales, with suspected LHO during the epoch 1996-2016.
Results: A total of 273 neonates were included; 240 with confirmed LHO. Administration of prostaglandin E to infants with a structurally normal heart was not associated with impaired acid-base or oxygenation status. Pre-transport diagnostic accuracy of LHO was 74.4%; sensitivity 84.5%, positive predictive value 86.0%. On multivariable logistic regression, hepatomegaly (odds ratio 2.54; 95% confidence interval 1.05-6.16) was associated with confirmed LHO.
Conclusions: A low threshold for prostaglandin E infusion should be maintained in infants with suspected LHO. Hepatomegaly is associated with a diagnosis of LHO and may be more useful than other parameters in predicting the condition.
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| http://dx.doi.org/10.1111/jpc.15102 | DOI Listing |
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