Early Functional Closure of the Ductus Arteriosus Associated With Decreased Severity of Respiratory Distress Syndrome in Preterm Infants

Thibeault, Donald W.; Emmanouilides, George C.; Dodge, Michael; Lachman, Ralph S.

doi:10.1001/archpedi.1977.02120200023006

Cited by 4 publications

(4 citation statements)

References 21 publications

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“…I fa ts with either of these ris factors, regardless of fluid i ta e, birth weight, or gestatio al age, were at sig ifica t ris for developi g early hsPDA compared with the ifa ts without birth asphyxia a d severe RDS . These data are i agreeme t with those of previous studies that have oted a i creased ris of shu ti g through the PDA i i fa ts with severe RDS a d asphyxia [12,24] . Fluid restrictio has become sta dard therapy i the ma ageme t of the VLBW i fa t i the first days of life .…”

Section: Discussiosupporting

confidence: 90%

“…Sig ifica t left-to-right shu ti g through a patie t ductus arteriosus (PDA) has bee show to produce deleterious effects o lu g complia ce a d cardiac fu ctio that may complicate the hospital course of premature i fa ts with respiratory distress sydrome (RDS) [13,23,24] . This problem may be par- ticularly importa t i the ma ageme t of the very low birth weight (VLBW) i fa t [12,24] .…”

Section: Abstract : Pda -Echocardiography -Fluid Bala Ce -Vlbw I Fa Tsmentioning

confidence: 99%

“…This problem may be par- ticularly importa t i the ma ageme t of the very low birth weight (VLBW) i fa t [12,24] .…”

Section: Abstract : Pda -Echocardiography -Fluid Bala Ce -Vlbw I Fa Tsmentioning

confidence: 99%

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Hemodynamically significant PDA: An echocardiographic and clinical assessment of incidence, natural history, and outcome in very low birth weight infants maintained in negative fluid balance

et al. 1985

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Fifty very low birth weight (VLBW) infants (750-1500 g, 27-33 weeks gestational age) were assigned at random to one of two groups of negative fluid balance and underwent prospective clinical and echocardiographic examinations during the first month of life. The purpose was to determine: the effect of fluid restriction on the incidence of ductal shunting, the reliability of the physical examination in diagnosing significant ductal shunting, and the relationship between significant ductal shunting and outcome in such infants. None of the infants had manipulations to close the ductus during the first week of life. Using routine structural and functional echocardiographic indices as criteria for the diagnosis of hemodynamically significant ductal shunting (hsPDA), we found that the two fluid-balance groups (8%-10% weight loss vs 13%-15% weight loss) did not significantly differ in incidence of hsPDA, duration of ventilation, or development of BPD. These two groups were then combined for further analysis: 32 (64%) of 50 VLBW infants had hsPDA during the first week of life. The group of infants with hsPDA did not differ significantly from that without hsPDA in birth weight or gestational age, but had a significantly lower Apgar score (P less than 0.04) and was significantly more likely to require ventilator support for RDS (P less than 0.01). Although when present a typical ductal murmur was specific for the development of significant ductal shunting, no murmur was heard in 21 (66%) of 32 infants with early hsPDA.(ABSTRACT TRUNCATED AT 250 WORDS)

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Section: Discussiosupporting

confidence: 90%

Section: Abstract : Pda -Echocardiography -Fluid Bala Ce -Vlbw I Fa Tsmentioning

confidence: 99%

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Hemodynamically significant PDA: An echocardiographic and clinical assessment of incidence, natural history, and outcome in very low birth weight infants maintained in negative fluid balance

et al. 1985

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“…Exogenous surfactant administration may further increase left-to-right shunt through the ductus by reducing the pulmonary vascular resistance [4]. The incidence of PDA in preterm infants may be reduced by chronic intrauterine stress secondary to increased production of fetal glucocorticoids [19,23], and by administration of steroids antenatally [3,11,24]. However, only about 20% of high-risk mothers get a complete course of antenatal steroids [13].…”

mentioning

confidence: 99%

Effect of Dexamethasone Therapy on the Neonatal Ductus Arteriosus

Morales¹,

Rastogi²,

Bez³

et al. 1998

Pediatr Cardiol

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Patent ductus arteriosus (PDA) is believed to be a contributing factor in the etiopathogenesis of bronchopulmonary dysplasia (BPD). We studied the effects of early dexamethasone therapy on persistent ductal patency and the role of PDA in the etiopathogenesis of BPD during the course of a randomized double-blind trial of dexamethasone to prevent BPD. Infants, who weighed between 700 and 999 g, had severe RDS, and had been given surfactant, were randomized to receive a 12-day course of dexamethasone (n = 13) or placebo (n = 17) starting within the first 12 hours of postnatal life. The diagnosis of PDA was made clinically and was confirmed by cardiac ultrasound. The incidence of clinically significant ductus in infants who weighed less than 1000 g was 23% in the dexamethasone-treated group, as compared with 59% in infants who were given placebo. This difference was marginally significant, p = 0.05, odds ratio 0.21, 95% confidence interval 0.04-1.05. None of the infants in the dexamethasone group had recurrence of PDA after indomethacin therapy as compared with three infants in the placebo group. Dexamethasone significantly reduced the number of days infants required ventilator and supplemental oxygen as compared with infants who received placebo. Dexamethasone, as compared with placebo, also reduced the incidence of BPD, p = 0.025, odds ratio 0.08, 95% confidence interval 0.01-0.58. Dexamethasone may reduce the incidence of PDA in premature infants who weigh less than 1000 g at birth and thereby reduce the incidence of BPD.

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Normal radiographic heart volume in the neonate

1983

Pediatr Radiol

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The hypothesis that the normal distribution of relative heart volume in the neonatal period is a mixture of two different populations, with different means and variances, has been tested. The definition of the two populations was (i) normally patent ductus and (ii) closed ductus arteriosus. The assumed frequencies of the patency in different age-groups were taken from Gentile et coll. [5]. A material consisting of 100 neonates found to be normal has been analysed radiologically during the first 360 hours after birth. The results strongly supports the hypothesis and explains the large normal range of relative heart volume during the first 48 hours of life.

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Early Functional Closure of the Ductus Arteriosus Associated With Decreased Severity of Respiratory Distress Syndrome in Preterm Infants

Cited by 4 publications

References 21 publications

Hemodynamically significant PDA: An echocardiographic and clinical assessment of incidence, natural history, and outcome in very low birth weight infants maintained in negative fluid balance

Hemodynamically significant PDA: An echocardiographic and clinical assessment of incidence, natural history, and outcome in very low birth weight infants maintained in negative fluid balance

Effect of Dexamethasone Therapy on the Neonatal Ductus Arteriosus

Normal radiographic heart volume in the neonate

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