Patent ductus arteriosus complicating the respiratory distress syndrome in preterm infants

Congenital Anomalies in Infants with Congenital Hypothyroidism: Is It a Coincidental or an Associated Finding?

“…Available reports suggest that the inci dence of various extrathvroidal anomalies as sociated with CH varies quite considerably depending on the study population and geo graphic location [4][5][6][7][8][9][10][11][12][13][14][15][16][17], Although it is diffi cult to compare incidences of congenital Congenital Anom alies and H ypothyroidism anomalies in infants with CH from different centres because of the different methods of classification and reporting, it is of interest to find an unusually high incidence (19.8%) of major extrathyroidal anomalies in this study compared to the known incidence of major congenital malformations in the general pop ulation. This is in support of Majeed-Saidan et al [4] who reported an incidence of 23.8% in a small series from another centre in Riyadh, and comparable to what has been reported by Fernhoff et al [11], Bamforth et al [9], and Siebner et al [ 16] from three other centres in different geographic locations (ta ble 2).…”

Patent Ductus Arteriosus and Respiratory Outcome in Premature Infants

“…The increased pulmonary blood fl ow due to ductal shunting can have a signifi cant negative impact on the underlying disease process. Delayed recovery from the initial respiratory failure has been reported in infants who present with PDA [14][15][16][17][18][19] . Low plasma oncotic pressure and increased capillary permeability are common in premature infants with respiratory distress.…”

Persistent ductus arteriosus complicating the respiratory distress syndrome.

“…PDA has been diagnosed only in the presence of a murmur as described by Rowe and Lowe (1964) who have pointed out that, even in infancy, a clinical diagnosis without resort to cardiac catheterization is nearly always possible. However, Thibeault et al (1975) have suggested that large left-to-right ductal shunts might contribute to early mortality in RDS even in the absence of a murmur. The incidence of PDA complicating RDS in our series may therefore be an underestimate.…”

“…Operation, however, has frequently been performed several days after the development of heart failure, and perhaps much earlier ligation of the PDA would prevent the development of bronchopulmonary dysplasia and improve the results of surgically treated cases (Gupta et al, 1972;Edmunds et al, 1973;Gay et al, 1973;Neal et al, 1975). Assessment of the size of a left-to-right ductal shunt by single injection aortography via the umbilical arterial catheter (Thibeault et al, 1975) and noninvasive measurement of left atrial and left ventricular size by echocardiography (Silvermann et al, 1974;Baylen et al, 1975) may help to select those cases requiring surgery. Our results suggest that in conjunction with these specialized investigations an inability to wean from assisted ventilation may define that group of infants with PDA complicating RDS who are most likely to benefit form early PDA ligation.…”

“…Most workers consider that heart failure should be managed medically at first, and that surgical ligation of the PDA should be performed when medical management is unsuccessful, and when heart failure results in an inability to wean from assisted ventilation (Gupta et al, 1972;Kitterman et al, 1972;Edmunds et al, 1973;Thibeault et al, 1975). Earlier ligation however has been suggested, since the presence of a left-toright shunting PDA in the infant with RDS may Received 9 August 1976 lead to a progressive deterioration in lung function and the possible development of bronchopulmonary dysplasia (Gupta et al, 1972;Gay et al, 1973;Neal et al, 1975;Thibeault et al, 1975). The latter complication has been one of the major factors responsible for the poor results of ductus ligation in most reported series (Edmunds et al, 1973;Gay et al, 1973).…”