01 March 2017

Evolution of pulmonary pressure in healthy newborns, in the first three months of life, in Bogota, located at 2.640 meters over sea level (MOSL)

Introduction

The effect of altitude is more significant over 2.500 MOSL. There is no knowledge about the evolution of pulmonary pressure in healthy newborns between 2.500 and 3.000 MOSL

Objective

To evaluate by echocardiogram the evolution of pulmonary pressure in healthy newborns in the postnatal life at 2.640 MOSL.

Material and methods

Prospective, descriptive study. 52 healthy newborns were evaluated by echocardiography, after clinical cardiovascular evaluation, looking to rule out any CV pathology. The first echocardiogram to valuate the SPP was made around 24 hours after delivery, with controls at 72 hours of life, one month and 3 months. The SPP was valuated through the tricuspid regurgitation jet, using the Bernoulli modified equation. It was only accepted when an excellent and repetitive regurgitation spectral curve was registered.

Results

The median for the first echocardiogram was 20 hours and for the second one, 96 hours. In the first echocardiogram, in 49 of 52 newborns we were able to get an excellent tricuspid regurgitation curve. The median of the SPP was 30 mm Hg; 25 percentil: 27 mm Hg and 75 percentil: 40 mm Hg; (Range: 17-68 mm Hg). In 5 Newborns the SPP was 50 mm Hg or higher.

Conclusion

10.2% of healthy neonates that are born at 2.640 MOSL without any risk factors in the perinatal period, showed delay of the drop of SPP in the first hours of life. The only factor that influenced this finding was the effect of hypobaric hypoxia by altitude. This study brings light on the major frequency of persistent pulmonary hypertension of the newborn at altitude.

Key Contributors

Gabriela Jacome, Alicia Marquez, Ariel Ruiz, Gabriel Díaz Universidad Nacional de Colombia, Clínica De La Mujer, CPO


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