| Right-to-left shunting in the ductus arteriosus is induced readily by intense crying and rapid postural change in neonates with meconium-stained amniotic fluid* | |
| | |
MedLine Citation:
|
PMID: 21460760 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
OBJECTIVE:: To investigate postnatal changes in the direction of blood flow through the ductus arteriosus in neonates with meconium-stained amniotic fluid, we measured preductal and postductal oxygen saturation in normal neonates, neonates with meconium-stained amniotic fluid, and a neonate with persistent pulmonary hypertension of the newborn. DESIGN:: Prospective, observational case series report. SETTING:: A single, tertiary neonatal intensive care unit. PATIENTS:: Twelve normal neonates, seven neonates with meconium-stained amniotic fluid, and a neonate with persistent pulmonary hypertension of the newborn. INTERVENTIONS:: SpO2 is simultaneously monitored in the right upper and lower limbs after birth. MEASUREMENTS AND MAIN RESULTS:: Compared with normal neonates, three neonates with meconium-stained amniotic fluid required longer than +2 SD of the mean time for the postductal SpO2 to reach 90% and/or 95%. In a neonate with meconium-stained amniotic fluid, intense crying triggered frequent decreases to <70% in the postductal SpO2 from 25 mins after birth, while the preductal SpO2 remained at 95% or above. When the other newborn with meconium-stained amniotic fluid was held in the father's arms after 98 mins, the postductal SpO2 decreased rapidly to <80%, while the preductal SpO2 remained at 95%. Thus, 5% or greater difference between the preductal and postductal SpO2 was observed from 25 mins after birth until 120 mins in all neonates with meconium-stained amniotic fluid, whereas the difference disappeared after 25 mins in 12 normal neonates. In a neonate with persistent pulmonary hypertension of the newborn who required vigorous resuscitation, 5% or greater difference between the preductal and postductal SpO2 levels was observed until 6 hrs after birth. CONCLUSIONS:: Right-to-left shunting in the ductus arteriosus may be induced readily by intense crying and rapid postural change in infants with meconium-stained amniotic fluid. It is important to monitor SpO2 at both pre- and postductal regions until 120 mins after birth in neonates with meconium-stained amniotic fluid and to subject these infants to minimal manipulations. |
| | |
Authors:
|
Atsushi Baba; Takefumi Ishida; Mayumi Okada; Yohei Akazawa; Kanae Hirabayashi; Ken Saida; Kesami Sakaguchi; Kenichi Koike |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2011-3-31 |
Journal Detail:
|
Title: Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies Volume: - ISSN: 1529-7535 ISO Abbreviation: - Publication Date: 2011 Mar |
Date Detail:
|
Created Date: 2011-4-4 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 100954653 Medline TA: Pediatr Crit Care Med Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
|
From the Departments of Pediatrics (Drs. Baba, Ishida, Okada, Akazawa, Hirabayashi, Saida, Koike) and Nursing (Dr. Sakaguchi), Shinshu University School of Health Sciences, Matsumoto, Nagano, Japan. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Importance of NOD2/CARD15 gene variants for susceptibility to and outcome of sepsis in Turkish child...
Next Document: Stool Calprotectin Monitoring After Small Intestine Transplantation.