Diagnostics of myocardial damage in premature newborns with transient heart disease in the early neonatal period

Rossijskij Vestnik Perinatologii i Pediatrii

O. A. Vazemiller¹  A. A. Vaganov¹  A. B. Salmina¹  E. Yu. Emelyanchik¹  N. K. Golubenko²  R. Kh. Aksanova² 

[1] Krasnoyarsk regional clinical center of maternity and childhood;Voino-Yasenetsky Krasnoyarsk State Medical University;

关键词: newborns;    myocardial destruction;    transient myocardial ischemia;    respiratory failure;    troponin i;    diagnostics;   

DOI  :  10.21508/1027-4065-2019-64-5-38-43

来源: DOAJ

【 摘 要 】

Purpose. To assess frequency and severity of myocardial damage in premature infants with transient myocardial ischemia in the early neonatal period.Materials and methods. The study includes 73 newborns of a gestational age of 31–36 weeks with respiratory failure and oxygen dependence in the first 2 hours of life. Newborns are divided into groups: Group 1: classic electrocardiographic criteria of transient myocardial ischemia and an increase in the level of troponin I in the blood; Group 2: electrocardiographic criteria for transient myocardial ischemia and a normal level of troponin I; Group 3: no ECG changes and normal troponin I level. We assessed blood gases, conducted electrocardiography, determined troponin I in the blood on the 1st and 7th day of life, assesses duration of oxygen therapy in all the children.Results. Group I: troponin I concentration on the 7th day of life – 0.415 [0.222; 0.639] ng/ml, Group II – 0.073 [0.051; 0.104] ng/ml and Group III – 0.017 [0.006; 0.051] ng/ml. Transient myocardial ischemia was detected in 41% of examined patients, and destructive myocardial changes – in 21.9%. An analysis of the gas composition of blood in the first 2 hours demonstrated that there was a significant predominance of the level of bases in the children of Group I. The duration of artificial ventilation in children of Group I was 56 [3; 96] hours, exceeding the indicators of children of Group II (9 [8; 11]) by 5 times, and Group III (20.5 [13; 72]) – by 2.5 times. Also newborns in Group I experienced a maximum need for oxygen therapy through a mask.Conclusion. 21.9% of premature infants experience destructive myocardial changes against the background of transient myocardial ischemia; newborns with transient myocardial ischemia and destructive changes have a significantly more pronounced metabolic acidosis in the first hours of life and a longer need for oxygen therapy.

【 授权许可】

Unknown