Document Detail

Patent ductus arteriosus ligation and post-operative hemodynamic instability: case report and framework for enhanced neonatal care.
MedLine Citation:
PMID:  20740386     Owner:  NLM     Status:  MEDLINE    
Ligation of a patent ductus arteriosus can lead to severe cardiorespiratory compromise in preterm infants. This report reviews the postoperative course of a patient with significant cardiorespiratory instability following surgical ligation of the patent ductus arteriosus and presents a framework for enhanced cardiovascular care in this population. A preterm infant, born at 24 wk gestation underwent ligation of a large haemodynamically significant ductus arteriosus after failure of 2 courses of indomethacin. He developed systemic hypotension, which was aggressively treated with high doses of multiple cardiotropic agents. After 10 hr of refractory hypotension, the addition of hydrocortisone normalized blood pressure. This article outlines preprocedural categorization of infants according to ductal illness severity which facilitates the risk assignment for postoperative deterioration, development of clinical guidelines specific to the likely haemodynamic changes, enhanced role of functional echocardiography for guiding therapy, and interprofessional education.
Arvind Sehgal; Johny Vakayil Francis; Andrew James; Patrick J McNamara
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2010-08-26
Journal Detail:
Title:  Indian journal of pediatrics     Volume:  77     ISSN:  0973-7693     ISO Abbreviation:  Indian J Pediatr     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2011-08-05     Completed Date:  2012-03-20     Revised Date:  2012-08-31    
Medline Journal Info:
Nlm Unique ID:  0417442     Medline TA:  Indian J Pediatr     Country:  India    
Other Details:
Languages:  eng     Pagination:  905-7     Citation Subset:  IM    
Monash Newborn, Monash Children's, VIC, Australia.
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MeSH Terms
Ductus Arteriosus, Patent / surgery*
Hypotension / etiology*,  therapy
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / surgery*
Postoperative Care
Postoperative Complications* / therapy
Comment In:
Indian J Pediatr. 2012 Apr;79(4):543-4   [PMID:  21769522 ]

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