Document Detail


Haemodynamic changes after delivery room surfactant administration to very low birth weight infants.
MedLine Citation:
PMID:  20538711     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Surfactant replacement therapy (SRT) reduces respiratory morbidity and mortality in premature infants. The goal of this study was to characterise the effects of delivery room SRT on the ductus arteriosus and early neonatal haemodynamics. METHODS: A prospective observational study was conducted in preterm infants of less than 32 weeks' gestation who received SRT within 30 min of birth. Serial echocardiography was performed before and after SRT. Characteristics of the ductus arteriosus, myocardial performance, right ventricular output (RVO) and left ventricular output (LVO) and the ratio of RVO:LVO were measured. RESULTS: Sixteen babies, born at 28.3+/-1.3 weeks' gestation and weighing 1289+/-224 g, were studied. SRT was associated with an improvement in the arterial oxygen tension:fractional inspired oxygen ratio (p<0.001), increased systolic and decreased diastolic arterial pressure (p<0.05). The ductus arteriosus was patent in all and transductal flow was unrestrictive and exclusively left-to-right after SRT. An increase in transductal diameter (p<0.001), left atrium:aortic ratio (p=0.006) but a decrease in left ventricular end-diastolic dimension (p=0.02) was identified. CONCLUSION: SRT administration was followed by increased RVO but decreased LVO, resulting in an increased RVO:LVO ratio and an increase in ductal size. Delivery room administration of SRT is associated with major haemodynamic changes. The impact of these changes needs prospective evaluation.
Authors:
Arvind Sehgal; Wendy Mak; Michael Dunn; Edmond Kelly; Hilary Whyte; B McCrindle; Patrick J McNamara
Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2010-06-10
Journal Detail:
Title:  Archives of disease in childhood. Fetal and neonatal edition     Volume:  95     ISSN:  1468-2052     ISO Abbreviation:  Arch. Dis. Child. Fetal Neonatal Ed.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-18     Completed Date:  2010-10-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9501297     Medline TA:  Arch Dis Child Fetal Neonatal Ed     Country:  England    
Other Details:
Languages:  eng     Pagination:  F345-51     Citation Subset:  AIM; IM    
Affiliation:
Division of Neonatology, The Hospital for Sick Children, Toronto, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adult
Birth Weight
Ductus Arteriosus / drug effects*,  ultrasonography
Female
Gestational Age
Hemodynamics / drug effects*
Humans
Infant, Newborn
Infant, Premature
Infant, Very Low Birth Weight*
Male
Perinatal Care / methods
Prospective Studies
Pulmonary Surfactants / pharmacology*,  therapeutic use
Respiratory Distress Syndrome, Newborn / prevention & control
Ventricular Function, Left / drug effects
Ventricular Function, Right / drug effects
Chemical
Reg. No./Substance:
0/Pulmonary Surfactants

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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