Patent ductus arteriosus and cerebral, cardiac, and gut hemodynamics in premature neonates

J L Ruoss; C Bazacliu; R E Giesinger; P J McNamara

doi:10.1016/j.siny.2020.101120

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Patent ductus arteriosus and cerebral, cardiac, and gut hemodynamics in premature neonates

Journal article

Peer reviewed

Patent ductus arteriosus and cerebral, cardiac, and gut hemodynamics in premature neonates

J L Ruoss, C Bazacliu, R E Giesinger and P J McNamara

Seminars in fetal & neonatal medicine, Vol.25(5), pp.101120-101120

10/2020

DOI: 10.1016/j.siny.2020.101120

PMID: 32513596

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Abstract

Patent ductus arteriosus is associated with multiple comorbidities in premature infants, however a causal link or strategy to decrease these morbidities has not been found. The association between the patent ductus arteriosus and morbidities has biologic plausibility as, like any cardiac mixing lesion, a significant systemic to pulmonic shunt may lead to pulmonary over-circulation and systemic hypoperfusion. Understanding the underlying pathophysiology of associated morbidities in the setting of a patent ductus arteriosus may aid in risk stratifying infants and offer a patient targeted approach to infants with a pathological ductal shunt. While the deleterious impact of increased pulmonary blood flow maybe easier to identify, the impact on end-organ perfusion is more challenging. In this review, we will discuss the pathophysiology of a hemodynamically significant patent ductus arteriosus in premature infants, impact on end-organ perfusion and associated morbidities, and novel modalities to assess shunt volume and effect on end-organ perfusion.

Systemic hypoperfusion

Necrotizing enterocolitis

Intraventricular hemorrhage

Patent ductus arteriosus

Systemic hypotension

Details

Title: Subtitle: Patent ductus arteriosus and cerebral, cardiac, and gut hemodynamics in premature neonates
Creators: J L Ruoss - Division of Neonatology, Department of Pediatrics, University of Florida, 1600 SW Archer Rd, Gainesville, FL, 32608, USA
C Bazacliu - Division of Neonatology, Department of Pediatrics, University of Florida, 1600 SW Archer Rd, Gainesville, FL, 32608, USA
R E Giesinger - University of Iowa
P J McNamara - University of Iowa
Resource Type: Journal article
Publication Details: Seminars in fetal & neonatal medicine, Vol.25(5), pp.101120-101120
DOI: 10.1016/j.siny.2020.101120
PMID: 32513596
ISSN: 1744-165X
eISSN: 1878-0946
Language: English
Date published: 10/2020
Academic Unit: Stead Family Department of Pediatrics; Neonatology; Internal Medicine
Record Identifier: 9984354119702771

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