Effects of a clinically detectable PDA on pulmonary mechanics measures in VLBW infants with RDS.
We examined the effect of a clinically detectable patent ductus arteriosus (PDA) and its successful treatment with indomethacin on serial measures of pulmonary mechanics in 10 very-low-birthweight (VLBW) intubated infants with respiratory distress syndrome (RDS). Pulmonary mechanics were measured by the passive expiratory flow technique. Total respiratory system compliance (Crs) gradually improved as RDS resolved. However, a significant decrease in mean Crs was associated with the development of a clinically detectable PDA, ranging from 1.51 +/- 0.21 to 0.90 +/- 0.08 mL/cmH2O/m (P less than 0.05). We also noted an increase in mean Crs, from 0.90 +/- 0.08 to 1.49 +/- 0.21 mL/cmH2O/m (P less than 0.05), after successful treatment of a PDA with indomethacin. Total respiratory system resistance (Rrs) did not change. We conclude that a clinically significant PDA is associated with a decreased Crs and that successful treatment of a PDA with indomethacin is associated with an improvement in lung compliance. These findings imply that the development of a clinically detectable PDA and its subsequent treatment complicates the interpretation of pulmonary mechanics data in VLBW infants with RDS.
Balsan
M J
MJ
Department of Pediatrics, Magee Womens Hospital, University of Pittsburgh School of Medicine, PA 15213.
Jones
J G
JG
Guthrie
R D
RD
D000403:Airway Resistance / Q000187:drug effects / Q000502:physiology; D004374:Ductus Arteriosus, Patent / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use; D007230:Infant, Low Birth Weight / Q000502:physiology*; D007231:Infant, Newborn; D008170:Lung Compliance / Q000187:drug effects / Q000502:physiology*; D008297:Male; D012127:Respiratory Distress Syndrome, Newborn / Q000188:drug therapy / Q000503:physiopathology*; D012189:Retrospective Studies
D007213:Indomethacin