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Catecholamine-resistant hypotension and myocardial performance following patent ductus arteriosus ligation
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نویسنده
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Noori S ,McNamara P ,Jain A ,Lavoie P M ,Wickremasinghe A ,Merritt T A ,Solomon T ,Sekar K ,Attridge J T ,Swanson J R ,Gillam-Krakauer M ,Reese J ,Poindexter B B ,Brook M ,Auchus R J ,Clyman R I
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منبع
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journal of perinatology - 2015 - دوره : 35 - شماره : 2 - صفحه:123 -127
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چکیده
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Objective:we performed a multicenter study of preterm infants, who were about to undergo patent ductus arteriosus ligation, to determine whether echocardiographic indices of impaired myocardial performance were associated with subsequent development of catecholamine-resistant hypotension following ligation.study design:a standardized treatment approach for hypotension was followed at each center. infants were considered to have catecholamine-resistant hypotension if their dopamine infusion was >15 μg kg–1min–1. echocardiograms and cortisol measurements were obtained between 6 and 14 h after the ligation (prior to the presence of catecholamine-resistant hypotension).result:forty-five infants were enrolled, 10 received catecholamines (6 were catecholamine-responsive and 4 developed catecholamine-resistant hypotension). catecholamine-resistant hypotension was not associated with decreased preload, shortening fraction or ventricular output. infants with catecholamine-resistant hypotension had significantly lower levels of systemic vascular resistance and postoperative cortisol concentration.conclusion:we speculate that low cortisol levels and impaired vascular tone may have a more important role than impaired cardiac performance in post-ligation catecholamine-resistant hypotension.
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آدرس
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University of South California, Department of Pediatrics, USA. University of Oklahoma, Department of Pediatrics, USA, Hospital for Sick Children, Department of Pediatrics, Canada, Hospital for Sick Children, Department of Pediatrics, Canada. University of Toronto, Department of Pediatrics, Canada, Department of Pediatrics Children’s & Women’s Health Centre of British Columbia, Canada, University of California San Francisco, Department of Pediatrics, USA, Loma Linda University, Department of Pediatrics, USA, Loma Linda University, Department of Pediatrics, USA, University of Oklahoma, Department of Pediatrics, USA, University of Virginia, Department of Pediatrics, USA, University of Virginia, Department of Pediatrics, USA, Vanderbilt University, Department of Pediatrics, USA, Vanderbilt University, Department of Pediatrics, USA, Indiana University, Department of Pediatrics, USA, University of California San Francisco, Department of Pediatrics, USA, University of Michigan, Department of Medicine, USA, University of California San Francisco, Department of Pediatrics, USA
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Authors
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