Increased shunt through the patent ductus arteriosus after surfactant replacement therapy.
Increased shunt through the patent ductus arteriosus after surfactant replacement therapy.
复制标题
表面活性剂替代治疗后通过动脉导管未闭的分流增加。
DOI：
10.1016/s0022-3476(82)80247-3
复制
发表时间：
1982
期刊：
影响因子：
--
通讯作者：
Mauray,F
中科院分区：
文献类型：
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作者：
Clyman,RI;Jobe,A;Heymann,M;Ikegami,M;Roman,C;Payne,B;Mauray,F
呼吸窘迫综合征早产儿气管内滴入表面活性物质与90%的动脉导管未闭发生率相关。我们研究了表面活性物质治疗对12只早产羔羊动脉导管的影响。通过放射性微球注射计算动脉导管和全身血流量。出生后30分钟，所有人都出现呼吸衰竭（pH<7.1，PaCO 2>60）。在出生后30至60分钟之间，对6只羔羊气管滴注50 mg/kg表面活性剂脂质。出生后2小时，给药羔羊的pH值（7.27±0.02 vs 6.97±0.08）和PaCO 2（43.3±4.1 vs 85±15）与对照组存在显著差异。动脉血氧分压（PaO 2）、前列腺素E2（PGE 2）浓度和动脉导管阻力无差异，但动脉导管分流明显增大。这种增加的分流是由于肺血管阻力的显著下降，而不是由于动脉导管通畅性的变化。表面活性剂替代可能需要专门针对患病早产儿动脉导管未闭的干预措施。
Instillation of surfactant into the trachea of preterm infants with respiratory distress syndrome is associated with a 90% incidence of patent ductus arteriosus. We studied the effects of surfactant therapy on the ductus arteriosus in 12 preterm lambs. Flow across the ductus arteriosus and systemic blood flow were calculated from radioactive microsphere injections. All developed respiratory failure (pH<7.1, PaCO2>60) by 30 minutes after birth. Between 30 and 60 minutes after birth, six lambs were treated with tracheal instillation of 50 mg/kg surfactant lipid. By two hours after birth, treated lambs differed significantly from controls in pH (7.27±0.02 vs 6.97±0.08) and PaCO2(43.3±4.1 vs 85±15). There were no differences in PaO2or PGE2concentrations or ductus arteriosus resistance, but there was a significantly larger shunt through the ductus arteriosus in treated lambs. This increased shunt resulted from the significant drop in pulmonary vascular resistance and not from a change in patency of the ductus arteriosus. Surfactant replacement may require interventions directed specifically at the patent ductus arteriosus in sick preterm infants.