Document Detail

Impaired lung function after intubation and mechanical ventilation for surgical ligation of the ductus arteriosus in preterm infants.
MedLine Citation:
PMID:  21398143     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Significant patent ductus arteriosus (PDA) in the preterm infant has been associated with pulmonary edema and impaired gas exchange. Therefore, surgical ligature of the DA may be required. However, the effects of intubation and mechanical ventilation on the PDA-induced lung dysfunction presently are unknown. The aim of the study was to investigate whether intubation and mechanical ventilation alter pulmonary function in the preterm infant with significant PDA.
DESIGN: A prospective study.
SETTING: The neonatal intensive care unit and department of anesthesiology in a university hospital.
PARTICIPANTS: Preterm infants <32 weeks' gestational age treated with nasal continuous positive airway pressure (NCPAP) and requiring mechanical ventilation for undergoing surgical DA ligature.
INTERVENTIONS: Respiratory, Doppler echocardiographic parameters, and chest x-ray transparencies of the lungs were measured during NCPAP and 2 hours after intubation and starting mechanical ventilation.
MEASUREMENTS AND MAIN RESULTS: Twenty preterm infants (gestational age = 27 ± 1 wk, birth weight = 950 ± 140 g) were included. Heart rate, O(2) need, PaCO(2), and plasma lactate concentrations were significantly higher after intubation. The mean oxygenation index increased from 1.5 ± 0.6 to 7.2 ± 3 (p < 0.05). The overall transparencies of the lungs decreased after intubation. DA diameter, shortening fraction of the left ventricle, left pulmonary artery blood flow velocities, and left atrium/aorta did not change.
CONCLUSION: In preterm infants with significant PDA, intubation and mechanical ventilation before surgical DA ligation may increase the O(2) need and PaCO(2) and may promote lung edema formation. Mechanical ventilation-induced impairment in lung function is not associated with a change in pulmonary or systemic circulation or DA flow. Special care should be taken to prevent respiratory failure when intubation and mechanical ventilation are required for undergoing surgical DA ligation in the preterm infant.
Thierry Dzukou; Thameur Rakza; Antoine Bouissou; Ceneric Alexandre; Serge Dalmas; Laurent Storme
Related Documents :
3893843 - Stimulation in the nicu: is more necessarily better?
1641083 - Unilateral thalamic haemorrhage in the pre-term and full-term newborn.
6660883 - Polymorphonuclear leucocyte transfusion in neonatal septicaemia.
Publication Detail:
Type:  Journal Article     Date:  2011-03-12
Journal Detail:
Title:  Journal of cardiothoracic and vascular anesthesia     Volume:  25     ISSN:  1532-8422     ISO Abbreviation:  J. Cardiothorac. Vasc. Anesth.     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-11-28     Completed Date:  2012-04-11     Revised Date:  2012-09-04    
Medline Journal Info:
Nlm Unique ID:  9110208     Medline TA:  J Cardiothorac Vasc Anesth     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1000-4     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Department of Perinatal Medicine, Hopital Jeanne de Flandre, CHRU de Lille, Lille, France.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Blood Gas Analysis
Blood Pressure / physiology
Continuous Positive Airway Pressure
Ductus Arteriosus / surgery*
Echocardiography, Doppler, Color
Heart Rate / physiology
Infant, Newborn
Infant, Premature
Lung / physiology*
Oxygen / blood
Respiration, Artificial / adverse effects*,  methods*
Respiratory Function Tests
Vena Cava, Superior / physiology
Ventricular Function, Left / physiology
Reg. No./Substance:
Comment In:
J Cardiothorac Vasc Anesth. 2012 Aug;26(4):e39-40; author reply e40-1   [PMID:  22480630 ]

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

Previous Document:  VEGF and IL-18 in induced sputum of lung cancer patients.
Next Document:  Endovascular Stenting or Carotid Endarterectomy for Treatment of Carotid Stenosis: A Meta-analysis.