Journal article
Haemodynamic changes after delivery room surfactant administration to very low birth weight infants
Archives of disease in childhood. Fetal and neonatal edition, Vol.95(5), pp.F345-F351
09/2010
DOI: 10.1136/adc.2009.173724
PMID: 20538711
Abstract
Introduction Surfactant replacement therapy (SRT) reduces respiratory morbidity and mortality in premature infants. The goal of this study was to characterise the effects of delivery room SRT on the ductus arteriosus and early neonatal haemodynamics. Methods A prospective observational study was conducted in preterm infants of less than 32 weeks' gestation who received SRT within 30 min of birth. Serial echocardiography was performed before and after SRT. Characteristics of the ductus arteriosus, myocardial performance, right ventricular output (RVO) and left ventricular output (LVO) and the ratio of RVO:LVO were measured. Results Sixteen babies, born at 28.3±1.3 weeks' gestation and weighing 1289±224 g, were studied. SRT was associated with an improvement in the arterial oxygen tension:fractional inspired oxygen ratio (p<0.001), increased systolic and decreased diastolic arterial pressure (p<0.05). The ductus arteriosus was patent in all and transductal flow was unrestrictive and exclusively left-to-right after SRT. An increase in transductal diameter (p<0.001), left atrium:aortic ratio (p=0.006) but a decrease in left ventricular end-diastolic dimension (p=0.02) was identified. Conclusion SRT administration was followed by increased RVO but decreased LVO, resulting in an increased RVO:LVO ratio and an increase in ductal size. Delivery room administration of SRT is associated with major haemodynamic changes. The impact of these changes needs prospective evaluation.
Details
- Title: Subtitle
- Haemodynamic changes after delivery room surfactant administration to very low birth weight infants
- Creators
- Arvind Sehgal - Division of Neonatology, The Hospital for Sick Children, Toronto, CanadaWendy Mak - Division of Neonatology, The Hospital for Sick Children, Toronto, CanadaMichael Dunn - Department of Paediatrics, University of Toronto, Toronto, CanadaEdmond Kelly - Department of Paediatrics, University of Toronto, Toronto, CanadaHilary Whyte - Division of Neonatology, The Hospital for Sick Children, Toronto, CanadaB McCrindle - Department of Paediatrics, University of Toronto, Toronto, CanadaPatrick J McNamara - Division of Neonatology, The Hospital for Sick Children, Toronto, Canada
- Resource Type
- Journal article
- Publication Details
- Archives of disease in childhood. Fetal and neonatal edition, Vol.95(5), pp.F345-F351
- Publisher
- BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
- DOI
- 10.1136/adc.2009.173724
- PMID
- 20538711
- ISSN
- 1359-2998
- eISSN
- 1468-2052
- Language
- English
- Date published
- 09/2010
- Academic Unit
- Stead Family Department of Pediatrics; Neonatology; Internal Medicine
- Record Identifier
- 9984093490102771
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