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Titolo:
HEMODYNAMIC PREDICTION OF COMPLICATIONS IN NEONATAL RESPIRATORY-DISTRESS SYNDROME
Autore:
SEPPANEN MP; KAAPA PO; KERO PO;
Indirizzi:
UNIV TURKU,DEPT PEDIAT,KIINAMYLLYNKATU 4-8 SF-20520 TURKU FINLAND
Titolo Testata:
The Journal of pediatrics
fascicolo: 5, volume: 127, anno: 1995,
pagine: 780 - 785
SICI:
0022-3476(1995)127:5<780:HPOCIN>2.0.ZU;2-J
Fonte:
ISI
Lingua:
ENG
Soggetto:
PATENT DUCTUS-ARTERIOSUS; BIRTH-WEIGHT INFANTS; SURFACTANT REPLACEMENT; PULMONARY HEMORRHAGE; SYNTHETIC SURFACTANT; INDOMETHACIN THERAPY; PRESSURE; DISEASE; NEWBORN; CLOSURE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
26
Recensione:
Indirizzi per estratti:
Citazione:
M.P. Seppanen et al., "HEMODYNAMIC PREDICTION OF COMPLICATIONS IN NEONATAL RESPIRATORY-DISTRESS SYNDROME", The Journal of pediatrics, 127(5), 1995, pp. 780-785

Abstract

Objectives. We hypothesized that the absence of an increase in the Doppler-derived aortopulmonary pressure gradient (APPG) across the ductus arteriosus, which reflects pulmonary artery pressure during the first day of rife, can predict clinical complications in preterm infants with neonatal respiratory distress syndrome (RDS). Study design. Twenty-nine healthy preterm infants weighing 2210 +/- 244 gm (mean +/- SEM) and 63 infants with RDS weighing 1645 +/- 86 gm were studied with the Doppler ultrasound technique for measurement of the mean APPG at 2, 24, 48, and 72 hours of age. Of infants with RDS, 67% were treated with synthetic surfactant. Results. Spontaneous closure of the ductus arteriosus on the first day of life led to exclusion of 11 infants with RDSand 17 control subjects from the study. Of the remaining 52 infants with RDS, 26 had an increase in the APPG from 2 to 24 hours of age, andAPPG values remained tow in the other 26 infants. Neonatal complications appeared more frequently (p <0.001) in distressed infants with little change in APPG values (Delta APPG) (22/26) than in infants with high Delta APPG (6/26). Six of the infants with high Delta APPG values (23%) needed medical or surgical closure of the ductus, but no other acute neonatal complications occurred; 14 ((54%) of the infants with lowDelta APPG required ductal closure. Between the ages of 24 and 58 hours, five of the latter 26 infants had severe pulmonary hemorrhage, which was fatal in two cases. Severe (grade II or IV) intraventricular hemorrhage was seen in three infants with RDS and a low Delta APPG; one of these infants also had severe pulmonary breeding. Pneumothorax occurred in six infants with a low Delta APPG. Infants without an increasein the APPG value during the first day of life required a significantly higher fraction of inspired oxygen. Conclusions. Noninvasive measurement of the change in APPG during the first day of life may provide auseful method for identifying infants with RDS at high risk of neonatal complications.

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Documento generato il 31/03/20 alle ore 19:41:45