[Effect of preoperative administration of prostaglandin E1 on cerebral blood flow in newborns with ductal-dependent congenital cardiac malformations].
Although the absolute number of congenital structural heart disease has not changed over the years, more and more infants undergo surgical interventions in the neonatal period, increasing the number of children and adults with post surgical status of cardiac disorders. Prostaglandin E1 (PGE1) is the first line drug to maintain or reopen the ductus arteriosus, until surgical intervention can be made. Cerebral blood flow (CBF) is regulated by multiple factors, like pO2, pCO2, pH, cardiac output and systemic blood pressure. The aim of the study was to determine how CBF changes after PGE1 administration in these newborns.


METHODS
We studied the pO2, pCO2, mean systemic blood pressure, and cerebral blood flow velocities by colored and pulsed Doppler ultrasonography in 36 newborns with ductal dependent cardiac malformation before and after prostaglandin E1 administration, and correlated them to normal values for the age.


RESULTS
We found that cerebral blood flow velocities followed the variations of blood pressure in restricted pulmonary circulation; improvement of oxygenation went parallel with decrease of cerebral diastolic velocities, and in aortic coarctation cerebral velocities decreased after introduction of PGE1.


CONCLUSIONS
PGE1 administration improved cerebral blood flow velocities in all forms of cardiac malformations, due to reorganization of cardiac output and changes in oxemia. Key
Simon
Marta
M
Universităţii de Medicină şi Farmacie Gr.T. Popa Iaşi, Universitatea de Medicină şi Farmacie TG. Mureş, Facultatea de Medicină.
Cucerea
Manuela
M
Dimitriu
A G
AG
Stamatin
Maria
M
D000527:Alprostadil / Q000008:administration & dosage / Q000494:pharmacology*; D001784:Blood Gas Analysis / Q000379:methods; D001794:Blood Pressure; D002245:Carbon Dioxide / Q000097:blood; D002302:Cardiac Output; D002560:Cerebrovascular Circulation / Q000187:drug effects*; D004334:Drug Administration Schedule; D004374:Ductus Arteriosus, Patent / Q000000981:diagnostic imaging* / Q000601:surgery*; D018619:Echocardiography, Doppler, Pulsed; D006330:Heart Defects, Congenital / Q000601:surgery; D006801:Humans; D007231:Infant, Newborn; D010100:Oxygen / Q000097:blood; D011300:Preoperative Care; D057234:Preoperative Period; D011446:Prospective Studies; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000494:pharmacology*
D014665:Vasodilator Agents; D002245:Carbon Dioxide; D000527:Alprostadil; D010100:Oxygen