Clinical Study Of Magnesium Sulfate In Neonatal Persistent Pulmonary Hypertension

Objective:neonatal persistent pulmonary hypertension?Neonatal per-sistent pulmonary hypertension,PPHN?is a common serious disease in neonatal period,which has a high fatality rate.A retrospective study was conducted on 87 cases of PPHN treated with magnesium sulfate to explore the efficacy of magnesium sulfate in the treatment of neonatal persistent pulmonary hypertension.Methods:A total of 87 newborns with persistent pulmonary hyperten-sion who met the inclusion criteria were collected from December 2009 to December 2019 in the second people's Hospital of Guangdong Province.According to gestational age,they were divided into preterm group?group??and full-term group?group??.On the basis of mechanical ventilation,maintenance of water and electrolyte balance,anti-infection,improvement of microcirculation,enteral nutrition,dopamine and dobutamine,magnesium sulfate was given on the basis of routine therapy,such as mechanical venti-lation,maintenance of water and electrolyte balance,anti-infection,im-provement of microcirculation,enteral nutrition,dopamine and dobutamine.The changes of the following indexes before and after treatment were com-pared:1.Transcutaneous oxygen saturation:the(Transcutaneous Oxygen Saturation,TcSaO2%index of transcutaneous oxygen saturation was ob-served before treatment,3 hours and 6 hours after treatment?right upper limb and other limbs?;2.Arterial blood gas analysis:comparison of arterial oxygen partial pressure(?Partial Pressure Of Oxygen,PaO₂?,arterial oxygen saturation?Arterial Oxygen Saturation,SaO₂?,arterial blood carbon dioxide partial pressure?Arterial Partial Pressure Of Carbon Dioxide,PaCO₂?,PH value,inhaled oxygen concentration?Fraction of inspiration O₂,FiO₂?before treatment and 12 hours,24 hours and 48 hours after treatment;3.Blood pressure:including pre-and post-treatment systemic systolic blood pressure?Systolic Blood Pressure,SBP?,systolic pulmonary artery pressure?Pulmo-nary Arterial Systolic Pressure,SPAP?;4.Heart rate?Heart Rate,HR?;5.Serum ions:dynamically monitor the changes of serum ions,including magnesium ion,potassium ion,calcium ion and sodium ion.Results:The TcSaO₂%before catheterization and TcSaO₂%after cathe-terization in the two groups increased 3 hours and 6 hours after magnesium sulfate treatment.After treatment for 12 hours,24 hours and 48 hours,PaO₂,SaO₂ and PH were significantly improved and FiO₂ decreased.The PaCO₂of preterm infants after magnesium sulfate treatment was significantly lower than that before treatment,while the PaCO₂ of term infants after magnesium sulfate treatment was lower than that before treatment,but there was no sig-nificant difference.The PASP of the two groups after magnesium sulfate treatment was lower than that before treatment.The systemic systolic blood pressure was normal before and after treatment.and the change was not sig-nificant.The heart rate of the two groups after treatment was slightly lower than that before treatment.Treatment outcome:group I?premature group?39cases,the total effective rate of magnesium sulfate after treatment was84.61%.Among them,4 cases died and 7 cases gave up.There were 48 cas-es in group??term group?.The total effective rate after magnesium sul-fate treatment was 89.58%.Among them,3 cases died and 5 cases gave up.There was no significant difference in the total effective rate of magnesium sulfate treatment between the two groups.Side effects:the systemic systolic blood pressure of the two groups were in the normal range before and after treatment,and there was no significant decrease.Dynamic monitoring showed that the levels of serum calcium and potassium decreased in varying degrees,and positively correlated with the increase of serum magnesium ion.No adverse reactions such as abdominal distension and disappearance of bowel sounds were found in clinic.Conclusion:1.Magnesium sulfate is effective in the treatment of neonatal persistent pulmonary hypertension,which can improve hypoxia and reduce the oxygen concentration of mechanical ventilation in the early stage;2.Magnesium sulfate has the same efficacy in the treatment of prema-ture infants with PPHN and term infants with PPHN;3.There was no significant change in systemic systolic blood pressure in children with PPHN,treated with magnesium sulfate on the basis of im-proving circulation with dopamine and dobutamine.