[Transient left myocardial dysfunction: a cause of neonatal hypoxemia].
Refractory hypoxemia in the newborn requires an accurate diagnostic investigation for an optimal and prompt management.


METHODS
After a short delivery, a post-term newborn developed a severe hypoxemia with patchy pulmonary alveolar opacities and systolic right-to-left extrapulmonary shunting through the ductus arteriosus. Echocardiography ruled out a cardiac malformation and showed dilated left atrium with left-to-right shunting by the ovale foramen due to left ventricular dysfunction. Inotropic support associated with mechanical ventilation allowed a rapid improvement.


CONCLUSIONS
A pathophysiological analysis is needed in case of severe neonatal hypoxemia. Doppler ultrasound is a non invasive and rapid method allowing the adjustment of the therapeutic strategy.
Feki
H
H
Service de réanimation néonatale et pédiatrique, hôpital Mère-Enfant, CHU Nantes, 9, Quai-Moncousu, 44093 Nantes, France.
Liet
J M
JM
Gournay
V
V
Rozé
J C
JC
D002316:Cardiotonic Agents / Q000627:therapeutic use; D004280:Dobutamine / Q000627:therapeutic use; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000209:etiology* / Q000628:therapy; D007231:Infant, Newborn; D008171:Lung Diseases / Q000209:etiology; D011650:Pulmonary Alveoli / Q000098:blood supply; D012121:Respiration, Artificial / Q000379:methods; D018487:Ventricular Dysfunction, Left / Q000150:complications*
D002316:Cardiotonic Agents; D004280:Dobutamine
Incompétence myocardique gauche transitoire: une cause d'hypoxémie néonatale.