Cerebral and splanchnic hemodynamics after duct ligation in very low birth weight infants.
OBJECTIVE
To describe mesenteric and cerebral blood flow velocities after surgical patent ductus arteriosus (PDA) closure in premature infants.


METHODS
We measured middle cerebral artery (MCA), celiac artery (CA), and superior mesenteric artery (SMA) Doppler ultrasound scanning blood flow velocity (BFV) preoperatively, 3 and 24 hours after ligation.


RESULTS
We studied 32 infants, with a mean (+/- SD) birthweight of 762 +/- 170 g and gestational age of 25.6 +/- 1.4 weeks at a mean age of 34 +/- 13 days. Significant changes in end-diastolic (EDV), average velocity (AV), and vascular resistance were measured in all 3 vessels by 3 hours. AV increased significantly in the CA and SMA within 3 hours; however, no significant increase in MCA AV was found until 24 hours after surgery.


CONCLUSIONS
PDA ligation significantly changes BFV in the MCA, CA, and SMA. In the MCA vascular tone is acutely modulated, with no change in AV at 3 hours. In the CA and SMA, AV increases acutely after ligation. These different patterns of change in BFV suggest region-specific adaptation to surgical PDA closure.
Hoodbhoy
Shazia A
SA
Guy's and St Thomas' NHS Foundation Trust, London, UK.
Cutting
Hazel A
HA
Seddon
James A
JA
Campbell
Morag E
ME
D001783:Blood Flow Velocity; D016022:Case-Control Studies; D002445:Celiac Artery / Q000000981:diagnostic imaging; D002560:Cerebrovascular Circulation; D003971:Diastole; D004374:Ductus Arteriosus, Patent / Q000601:surgery*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008026:Ligation; D008297:Male; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging; D011446:Prospective Studies; D013152:Splanchnic Circulation; D013997:Time Factors; D018608:Ultrasonography, Doppler; D014655:Vascular Resistance