Cardiocirculatory effects of patent ductus arteriosus in extremely low-birth-weight infants with respiratory distress syndrome.
BACKGROUND
Cardiocirculatory effects of hemodynamically significant patent ductus arteriosus (hsPDA) have not been systematically studied in extremely low-birth-weight (ELBW) infants with respiratory distress syndrome (RDS). The objective of the present study was to evaluate the effects of hsPDA on the left ventricular output (LVO) and organ blood flows in ELBW infants with RDS.


METHODS
Extremely low-birth-weight infants (birth-weight <1000 g) treated with surfactant for RDS were studied by serial Doppler flow examinations. Doppler flow variables in 19 infants in whom hsPDA developed (hsPDA group) were compared with those in 19 infants without hsPDA matched for gestational age, birth-weight, and postnatal age (non-hsPDA group). All infants in the hsPDA group had pharmacologic closure of ductus arteriosus when hsPDA developed.


RESULTS
Before pharmacological closure of PDA, the hsPDA group had significantly higher LVO, lower blood flow volume of the abdominal aorta, and lower mean blood flow velocities in the celiac artery, superior mesenteric artery, and renal artery than the non-hsPDA group. These alterations in the hsPDA group reverted to the levels in the non-hsPDA group after the closure of PDA and had no deleterious effects on the cardiorespiratory status. No significant differences between the groups were found in mean blood flow velocities of the anterior cerebral artery throughout the study period.


CONCLUSIONS
These results indicate that although LVO is increased, the splanchnic and renal blood flows are decreased when hsPDA develops in ELBW infants with RDS. The effects of these alterations of LVO and organ blood flows on the cardiorespiratory course seem to be minor when early pharmacologic closure of PDA is done.
Shimada
Senji
S
Department of Pediatrics, Iwate Medical University, Morioka, Iwate, Japan.
Kasai
Takeo
T
Hoshi
Atsuki
A
Murata
Atsushi
A
Chida
Shoichi
S
D001012:Aorta, Abdominal / Q000000981:diagnostic imaging; D001688:Biological Products; D001783:Blood Flow Velocity; D004374:Ductus Arteriosus, Patent / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D018618:Echocardiography, Doppler, Color; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008297:Male; D011663:Pulmonary Surfactants / Q000627:therapeutic use; D012079:Renal Circulation; D012127:Respiratory Distress Syndrome, Newborn / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D013152:Splanchnic Circulation; D016277:Ventricular Function, Left
D001688:Biological Products; D011663:Pulmonary Surfactants; C072197:beractant