Document Detail

The hemodynamically significant ductus arteriosus in critically ill full-term neonates. Two case reports?
MedLine Citation:
PMID:  17568157     Owner:  NLM     Status:  MEDLINE    
In premature infants, the clinical effects and management of a hemodynamically significant patent ductus arteriosus (HSDA) are well-described. In full-term neonates the ductus arteriosus (DA) is rarely monitored except in cases of concomitant pulmonary hypertension or duct dependent congenital heart disease. Although systemic-pulmonary shunting commonly occurs in mature infants, coinciding with the normal postnatal fall in pulmonary vascular resistance, cardiac failure in the neonatal period is rarely attributed directly to the DA. In this case series, we report two full-term infants who were initially treated for pulmonary hypertension and myocardial dysfunction but developed clinical, radiographic and two-dimensional echocardiographic evidence of cardiac failure secondary to a large unrestrictive patent DA (PDA). One patient was treated with indomethacin, and, although transductal diameter decreased, there was no clinical benefit. Cardiac failure resolved and myocardial function improved in both cases after PDA ligation. We suggest that PDA be monitored closely in neonates recovering from PPHN who have ongoing oxygenation difficulties or myocardial failure. PDA ligation should be considered an option for full term neonates with cardiac failure secondary to a HSDA when other therapeutic options fail.
Linh G Ly; Judith Hawes; Hilary E Whyte; Lilian S Teixeira; Patrick J McNamara
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2006-12-22
Journal Detail:
Title:  Neonatology     Volume:  91     ISSN:  1661-7800     ISO Abbreviation:  -     Publication Date:  2007  
Date Detail:
Created Date:  2007-06-18     Completed Date:  2007-09-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101286577     Medline TA:  Neonatology     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  260-5     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2007 S. Karger AG, Basel.
Division of Neonatology, The Hospital for Sick Children, Toronto, Canada.
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MeSH Terms
Cesarean Section
Critical Illness*
Delivery, Obstetric
Ductus Arteriosus / physiopathology*,  ultrasonography
Infant, Newborn
Treatment Outcome

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

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