Catecholamine-resistant hypotension and myocardial performance following patent ductus arteriosus ligation

Lavoie, Pascal M.; Gillam-Krakauer, Maria; Reese, Jeff; Poindexter, Brenda B.; Clyman, Ronald I.; Wickremasinghe, Andrea C.; Brook, Michael M.; Auchus, Richard J.; Matthews, Susan M.; Chomic, Robert; Brown, Stephen C.; Merritt, T. Allen; Solomon, Tabitha; Kuhn, Michael A.; McNamara, Patrick J.; Jain, Amish; El‐Khuffash, Afif; Luc, J. C. van Loon; Noori, Shahab; Sekar, Krishnamurthy; McCoy, Michael; Corff, Karen E.; Lavoie, Pascal; Claydon, Jennifer; Lusney, Nadine; Finlay, Kristi; Attridge, J T; Blackman, Amy; Swanson, Jonathan R.

doi:10.1038/jp.2014.151

Cited by 23 publications

(20 citation statements)

References 22 publications

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“…The other documented cause of circulatory compromise following PDA ligation is poor vascular tone, likely associated with the presence of adrenal insufficiency. This group of patients does not respond to dopamine or epinephrine and, in most of these patients, hydrocortisone reverses the circulatory compromise [53]. Unfortunately, pre-ligation assessment of adrenal function does not identify this group of patients.…”

Section: Contractilitymentioning

confidence: 82%

“…Cardiac dysfunction characterized by poor myocardial performance and decreased contractility is one of the underlying causes in a number of patients [51,52]. In this group, the most widely used vasopressor-inotrope, dopamine, appears to be effective in improving the circulatory compromise [50,53]. Prophylactic use of milrinone in a subset of patients with CO < 200 mL/kg/min has been reported to reduce post-ligation hypotension compared to historical controls [54].…”

Section: Contractilitymentioning

confidence: 97%

“…Unfortunately, pre-ligation assessment of adrenal function does not identify this group of patients. However, low serum cortisol levels a few hours after ligation may be helpful in identifying the patient with relative adrenal insufficiency who might benefit from steroid administration [50,53].…”

Section: Contractilitymentioning

confidence: 99%

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Evidence-based versus pathophysiology-based approach to diagnosis and treatment of neonatal cardiovascular compromise

Noori

Seri

2015

Seminars in Fetal and Neonatal Medicine

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Section: Contractilitymentioning

confidence: 82%

Section: Contractilitymentioning

confidence: 97%

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Evidence-based versus pathophysiology-based approach to diagnosis and treatment of neonatal cardiovascular compromise

Noori

Seri

2015

Seminars in Fetal and Neonatal Medicine

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“…However, there are some recommendations in the literature regarding the use of milrinone and dobutamine in the newborn, as well as some reservations, which led us to question their efficacy in the newborn period. 1,2,5,6,8,9,[12][13][14][15][16] In the current study, the aim was to understand the efficacy of milrinone and dobutamine when used on preterm infants with PLCS clinical signs developing after PDA ligation and which of these two medicines had a greater therapeutic effect. While doing this, the parameters of patient follow-up methods most commonly used in neonatal intensive care units (NICU) were considered.…”

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confidence: 99%

Which Inotropic Drug, Dobutamine or Milrinone, Is Clinically More Effective in the Treatment of Postligation Cardiac Syndrome in Preterm Infants?

et al. 2020

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Objective This study aimed to detect which of the two main medicines suggested in the treatment of postligation cardiac syndrome (PLCS)—dobutamine or mirinone—possesses a more therapeutic effect. While doing this, clinicians are provided with a broader perspective on the treatment and follow-up of cases. The desire was to increase the treatability and monitor ability of the cases in question and hence their survivability. Study Design A retrospective review of a cohort of infants with PLCS was conducted between March 2012 and December 2018. In the treatment of infants with PLCS, dobutamine (dobutamine study group-DSG) or milrinone (milrinone study group-MSG) was used. The respiration, cardiac, echocardiography, and perfusion parameters of the cases were assessed both before and after ligation. Based on the data obtained, both the effects of the medicines on PLCS and the difference between their therapeutic effects were studied. The accuracy of prognostication was assessed with receiver operating characteristic analyses. Results PLCS was detected in 29 (34.1%) of 85 patent ductus arteriosus ligation cases in total. Of all the PLCS cases, 13 (44.8%) were treated with dobutamine and 16 (55.2%) with milrinone. It was observed that the effects of the medicines on the respiratory system and cardiovascular system manifested in the third and 6th hour, respectively. It was detected that both medicines had more effect on the systolic blood pressure (SBP) (area under the curve [AUC]: 0.997/0.996, p = 0.001/0.002) than on the diastolic blood pressure (AUC: 0.911/0.843, p = 0.032/0.046). Conclusion Dobutamine and milrinone, two primary medicines that can be used in the treatment of cases with PLCS, possess similar therapeutic effects on this pathology. In addition, their postoperative therapeutic effects on the SBP are more in the foreground.

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“…본 . PLCS는 수술 후 혈압상승제가 요구되는 저혈압 및 호흡부전을 특징으로 하며 보통 수술 후 6시간에서 24시간 사이 에 발생하고 약 50%까지의 빈도로 보고되고 있다 6,7,18,19) . …”

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Risk Factors for Postoperative Cardiopulmonary Instability Following Ligation of Patent Ductus Arteriosus in Very Low Birth Weight Infants

et al. 2015

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Purpose: Patent ductus arteriosus (PDA) is common in preterm infants, and about 30% of preterm infants undergo surgical ligation of the PDA. Cardiopulmonary instability, defined as hypotension and respiratory failure after PDA ligation, is re ported to occur at a frequency of 4050%. This study investigated the factors affect ing cardiopulmonary instability after PDA ligation in preterm infants. Methods: The medical records of 45 very low birth weight (VLBW) infants who underwent PDA ligation in the neonatal intensive care unit from January 2009 to December 2013 were analyzed retrospectively. PDA ligation was only performed when medical treatment for hemodynamically significant PDA failed or was con traindicated. The cases were categorized into the hemodynamic instability (n=20) and control (n=25) groups. Results: Patients underwent ligation at the mean age of 14.3±13.3 days. There were no significant differences between groups in mortality or weaning from ventilation after PDA ligation. In the hemodynamic instability group, birth weight was signi ficantly lower (P=0.046) and the preoperation Creactive protein (CRP) level was significantly higher (P=0.042) than in the control group. The use of highfrequency ventilation was higher in the hemodynamic instability group (P=0.033). There were no differences in use of inotropics, mean airway pressure at ligation, timing of liga tion, or PDA size between groups. The birth weight and preoperation CRP level at the time of ligation remained a significant risk factor for cardiopulmonary inst ability on multiple logistic regression analysis. Conclusion: In VLBW infants, lower birth weight and a higher preoperation CRP level are related to unstable conditions after PDA ligation.

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Catecholamine-resistant hypotension and myocardial performance following patent ductus arteriosus ligation

Cited by 23 publications

References 22 publications

Evidence-based versus pathophysiology-based approach to diagnosis and treatment of neonatal cardiovascular compromise

Evidence-based versus pathophysiology-based approach to diagnosis and treatment of neonatal cardiovascular compromise

Which Inotropic Drug, Dobutamine or Milrinone, Is Clinically More Effective in the Treatment of Postligation Cardiac Syndrome in Preterm Infants?

Risk Factors for Postoperative Cardiopulmonary Instability Following Ligation of Patent Ductus Arteriosus in Very Low Birth Weight Infants

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