Early closure of the patent ductus arteriosus in very low-birth-weight infants: A controlled trial

Merritt, T. Allen; Harris, J. Peter; Roghmann, Klaus J.; Wood, Beverly P.; Campanella, V.; Alexson, Chloe; Manning, James A.; Shapiro, Donald L.

doi:10.1016/s0022-3476(81)80479-9

Cited by 127 publications

(45 citation statements)

References 22 publications

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“…An additional consequence of exogenous surfactant could be a decrease in pulmonary vascular resistance in the absence of ductal closure, resulting in left-to-right ciculatory shunt, cardiac failure, pulmonary edema, and deterioration of lung function. In the present study indomethacin was given early to prevent the adverse consequences of patent ductus ateriosus (26,27). Ductal closure rate with indomethacin was not altered by surfactant treatment.…”

Section: Discussionmentioning

confidence: 70%

Effect of Surfactant Substitution on Lung Effluent Phospholipids in Respiratory Distress Syndrome: Evaluation of Surfactant Phospholipid Turnover, Pool Size, and the Relationship to Severity of Respiratory Failure

et al. 1986

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ABSTRACT. The turnover and pool size of surfactant has Abbreviations been studied in animals, but there is little similar information in humans. In the present investigation lung effluent phospholipids were studied in 29 small preterm infants with severe RDS. Thirteen were treated with mechanical ventilation, and 16 additionally received natural human surfactant. The first dose (60 mg surfactantlkg body wt) was given between 2 and 10 h of age, and the surfactant was given again if there was an insufficient response. Together 260 aspirates, recovered during routine suctioning of the airways, were analyzed for phospholipids. Phosphatidylglycerol, present only in exogenous surfactant, was used as a specific marker to estimate the apparent pool size and the half-life of surfactant phospholipid. In addi-.tion, the saturated phosphatidylcholine/sphingomyelin ratios were correlated with the ventilatorv index (mean airway pressure X fractional inspiratory oxygen/arterial oxygen tension). There was a linear correlation between the ventilatory index and the saturated phosphatidylcholine/ sphingomyelin ( r --0.70) but no consistent correlation between the ventilatory index and the amount of phospholipids in the aspirate. The saturated phosphatidylcholine/ sphingomyelin ratio increased during the surfactant-induced remission of respiratory failure, decreased during the relapse of respiratory failure (present among 50% of the surfactant-treated infants), and increased again during the recovery. The control infants tended to have lower saturated phosphatidylcholine/sphingomyelin ratios during the first week than the surfactant-treated infants. Therecipients of surfactant had slightly more severe lung disease than the controls, when the results were adjusted by covariance to remove the differences in the saturated phosphatidylcholine/sphingomyelin ratio. Exogenous surfactant increased the amarent endogenous ~o o l size at least fivefold. The apparent half-life of ~hosph~tidylglycerol was 30 h (20-36 h). The half-life was independent of the amount of exogenous surfactant (60 versus 120 n~g/kg). Therefore, the apparent turnover rate after 120 was higher than after 60 mg/kg surfactant (p < 0.01).

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Section: Discussionmentioning

confidence: 70%

Effect of Surfactant Substitution on Lung Effluent Phospholipids in Respiratory Distress Syndrome: Evaluation of Surfactant Phospholipid Turnover, Pool Size, and the Relationship to Severity of Respiratory Failure

et al. 1986

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“…Mortality was reduced in only one study (22 subjects). 68 Among 27 studies that reported rates of BPD (using a variety of diagnostic criteria), one found a decrease 78 and two an increase 36,107 among treated infants. None reported reduced oxygen use at 28 days or 36 weeks postmenstrual age (PMA); one found more oxygen use at 36 weeks PMA.…”

Section: Findings From Individual Randomized-controlled Trialsmentioning

confidence: 99%

“…36 Of 25 studies reporting the combined outcome of death or BPD, only one showed a reduction. 78 A single trial of prophylactic ligation described a decrease in NEC, 64 and one trial of ibuprofen prophylaxis found more NEC, 87 but most found no effect. IVH rates were lower in 3 trials of prophylactic indomethacin, 91,96,98 2 trials reported lower rates of IVH>grade 2, 100,106 and 30 found no effect.…”

Section: Findings From Individual Randomized-controlled Trialsmentioning

confidence: 99%

Treatment of persistent patent ductus arteriosus in preterm infants: time to accept the null hypothesis?

2010

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“…It has been shown that surgical ligation of the PDA as well as closure after administration of indomethacin is associated with reduced ventilatory and oxygen requirements (6,7), and reduced incidence of bronchopulmonary dysplasia (8). Left to right shunting through the PDA increases pulmonary blood flow which may cause pulmonary edema with or without pulmonary venous hypertension, causing further derangements in the mechanics of breathing (9) and surfactant inactivation (10).…”

mentioning

confidence: 99%

Closure of the Ductus Arteriosus and Mechanics of Breathing in Preterm Infants after Surfactant Replacement Therapy

Heldt¹,

Pesonen

Merritt³

et al. 1989

Pediatr Res

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Early closure of the patent ductus arteriosus in very low-birth-weight infants: A controlled trial

Cited by 127 publications

References 22 publications

Effect of Surfactant Substitution on Lung Effluent Phospholipids in Respiratory Distress Syndrome: Evaluation of Surfactant Phospholipid Turnover, Pool Size, and the Relationship to Severity of Respiratory Failure

Effect of Surfactant Substitution on Lung Effluent Phospholipids in Respiratory Distress Syndrome: Evaluation of Surfactant Phospholipid Turnover, Pool Size, and the Relationship to Severity of Respiratory Failure

Treatment of persistent patent ductus arteriosus in preterm infants: time to accept the null hypothesis?

Closure of the Ductus Arteriosus and Mechanics of Breathing in Preterm Infants after Surfactant Replacement Therapy

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