EFFECT OF THE PATENT DUCTUS ARTERIOSUS ON THE PULMONARY BLOOD FLOW, BLOOD VOLUME, HEART RATE, BLOOD PRESSURE, ARTERIAL BLOOD GASES AND pH

PEDIATRICS ◽  
1950 ◽  
Vol 6 (4) ◽  
pp. 557-572
Author(s):  
DONALD E. CASSELS ◽  
MINERVA MORSE ◽  
W. E. ADAMS
Keyword(s):  
Heart Rate ◽  
Blood Flow ◽  
Patent Ductus Arteriosus ◽  
Blood Volume ◽  
Pulmonary Blood Flow ◽  
Ductus Arteriosus ◽  
Blood Gases ◽  
Arterial Blood Gases ◽  
Arterial Blood ◽  
Patent Ductus

The effect of the patent ductus arteriosus on the circulation and on the arterial blood gases and pHs has been studied. The pulmonary blood flow diminished 19.6 to 61.8% following ligation in 12 cases examined. The blood volume diminished following closure of the ductus in most cases. Likewise, the heart rate lessened and the pulse pressure was lower after surgery. Arterial oxygen saturation was low preoperatively in some cases and in most instances postoperatively, and this low value sometimes persisted. Some aspects of the data presented have been discussed in detail.

Cardiovascular effects of acute hemorrhage in fetal lambs

1981 ◽  
Vol 240 (1) ◽  
pp. H45-H48 ◽  
Author(s):  
P. L. Toubas ◽  
N. H. Silverman ◽  
M. A. Heymann ◽  
A. M. Rudolph
Keyword(s):  
Heart Rate ◽  
Blood Flow ◽  
Blood Volume ◽  
Age Groups ◽  
Blood Gases ◽  
Cardiovascular Effects ◽  
Carbon Dioxide Tension ◽  
Acute Hemorrhage ◽  
Arterial Blood ◽  
Placental Blood

The effects of acute hemorrhage were studied in two groups each with six fetal lambs (100-116 amd 128-147 days gestation) 3-4 days after we implanted catheters. Fetal blood pressures, heart rate, arterial blood gases and pH, and combined ventricular output and its distribution (radionuclide-labeled microsphere technique) were measured before and 5 min after removal of 15% of fetal-placental blood volume measured by 125I-albumin dilution. Because there were no differences in responses in the two age groups, the data were pooled. Fetal arterial mean pressure fell significantly (50.7 +/- 2.5 to 45.5 +/- 2.6 mmHg) as did heart rate (186 +/- 6 to 151 +/- 13 beats/min) and arterial blood pH (7.39 +/- 0.02 to 7.30 +/- 0.02); arterial blood carbon dioxide tension rose (39.7 +/- 29 to 44.1 +/- 4.4). Combined ventricular output fell from 610 +/- 58 to 448 +/- 45 ml . kg-1 . min-1 (P < 0.05). Blood flow to the umbilical-placental circulation, as well as to the fetal body, fell significantly. Blood flow to the kidneys, gastrointestinal tracts, and lungs also fell, but flow to other organs was maintained. Blood volume reduction in the fetus markedly influences blood gas exchange, because it results in a reduction of umbilical-placental blood flow associated with the fall in arterial pressure.

Range-gated pulsed Doppler ultrasonographic evaluation of carotid arterial blood flow in small preterm infants with patent ductus arteriosus

1983 ◽  
Vol 102 (2) ◽  
pp. 294-298 ◽  
Author(s):  
W. Dean Wilcox ◽  
Timothy A. Carrigan ◽  
Kenneth J. Dooley ◽  
Don P. Giddens ◽  
Francine D. Dykes ◽  
...  
Keyword(s):  
Blood Flow ◽  
Patent Ductus Arteriosus ◽  
Preterm Infants ◽  
Ductus Arteriosus ◽  
Arterial Blood Flow ◽  
Pulsed Doppler ◽  
Arterial Blood ◽  
Carotid Arterial ◽  
Patent Ductus

scholarly journals Patent Ductus Arteriosus Stenting for All Ductal-Dependent Cyanotic Infants

2021 ◽  
Vol 14 (3) ◽  
Author(s):  
Kanishka Ratnayaka ◽  
Stephen J. Nageotte ◽  
John W. Moore ◽  
Peter W. Guyon ◽  
Krishna Bhandari ◽  
...  
Keyword(s):  
Blood Flow ◽  
Length Of Stay ◽  
Patent Ductus Arteriosus ◽  
Pulmonary Blood Flow ◽  
Ductus Arteriosus ◽  
Pulmonary Arteries ◽  
Practice Change ◽  
Almost All ◽  
Blalock Taussig Shunt ◽  
Patent Ductus

Background: Ductal-dependent cyanotic newborns require a secure source of pulmonary blood flow. There has been a recent migration to selective ductal (patent ductus arteriosus [PDA]) stenting for some of these children. Universal (nonselective) ductal stenting for all infants with ductal-dependent pulmonary blood flow is controversial. We examine outcomes from a single center with this practice change. Methods: We compare outcomes of all ductal-dependent pulmonary blood flow infants (2013–2020 [January–June]) in the following treatment eras: Era 1 (selective PDA stenting; 2013–2017) or Era 2 (universal PDA stenting; 2018–2020 [January–June]). Results: Eighty-eight patients (Blalock-Taussig shunt, n=41; PDA stent, n=47) met inclusion criteria. In Era 1, most received Blalock-Taussig shunt (62% [41/66]). In Era 2, all received PDA stents (100% [22/22]). There were more females in Era 2, but otherwise no demographic differences between eras. There were no differences in mortality, treatment failures, complications, or reinterventions between eras. Postprocedure length of stay was shorter in Era 2 (8 versus 22 days, P =0.02). There were less surgical revisions for PDA stent patients (2% versus 20%, P =0.02). Postprocedure recovery surrogate end points favored Era 2 and PDA stenting. Additional analysis revealed PDA stent (compared with Blalock-Taussig shunt) patients had shorter post-procedure (10 versus 29 days, P ≤0.001) length of stay and more symmetrical branch pulmonary arteries (0.9 versus 0.7, P =0.001) at subsequent surgery. Conclusions: PDA stenting for almost all ductal dependent cyanotic newborns can be safe and effective and may have lower morbidity than selective PDA stenting.

Leukotriene end organ antagonists increase pulmonary blood flow in fetal lambs

1985 ◽  
Vol 249 (3) ◽  
pp. H570-H576 ◽  
Author(s):  
S. J. Soifer ◽  
R. D. Loitz ◽  
C. Roman ◽  
M. A. Heymann
Keyword(s):  
Heart Rate ◽  
Blood Flow ◽  
Pulmonary Vascular Resistance ◽  
Vascular Resistance ◽  
Pulmonary Circulation ◽  
Pulmonary Blood Flow ◽  
Blood Gases ◽  
Physiological Control ◽  
Arterial Blood ◽  
High Pulmonary Vascular Resistance

The factors responsible for maintaining the normally low pulmonary blood flow and high pulmonary vascular resistance in the fetus are not well understood. Since leukotrienes are potent pulmonary vasoconstrictors in many adult animal species, we determined whether leukotrienes were perhaps involved in the control of the fetal pulmonary circulation by studying the effects of putative leukotriene end organ antagonists in two groups of fetal lambs. In six fetal lambs studied at 130-134 days gestation, FPL 55712 increased pulmonary blood flow by 61% (P less than 0.05) and reduced pulmonary vascular resistance by 45% (P less than 0.05). There was a small increase in heart rate but no changes in pulmonary and systemic arterial pressures and systemic arterial blood gases. In six other fetal lambs studied at 130-140 days gestation, FPL 57231 increased pulmonary blood flow by 580% (P less than 0.05) and decreased pulmonary vascular resistance by 87% (P less than 0.05). Pulmonary and systemic arterial pressures decreased (P less than 0.05), and heart rate increased (P less than 0.05). Leukotriene end organ antagonism significantly increases fetal pulmonary blood flow and decreases pulmonary vascular resistance. Leukotrienes may play a role in the physiological control of the fetal pulmonary circulation.

Patent Ductus Arteriosus Banding for Circular Shunting After Pulmonary Valvuloplasty

2016 ◽  
Vol 8 (5) ◽  
pp. 643-645 ◽  
Author(s):  
Carles Bautista-Rodriguez ◽  
Javier Rodriguez-Fanjul ◽  
Julio Moreno Hernando ◽  
Javier Mayol ◽  
Jose Maria Caffarena-Calvar
Keyword(s):  
Blood Flow ◽  
Patent Ductus Arteriosus ◽  
Pulmonary Blood Flow ◽  
Pulmonary Valve ◽  
Ductus Arteriosus ◽  
Pulmonary Stenosis ◽  
Pulmonary Regurgitation ◽  
Increased Blood Flow ◽  
Critical Pulmonary Stenosis ◽  
Patent Ductus

We report two cases of newborns with critical pulmonary stenosis having intact ventricular septum, who underwent pulmonary valve balloon valvuloplasty followed by banding of a patent ductus arteriosus. Transcatheter pulmonary valvuloplasty was performed one week after delivery. Following the procedure, both developed “circular shunting” as a consequence of left-to-right ductal flow and pulmonary regurgitation. This in turn caused increased blood flow into a dysfunctional right ventricle and low systemic cardiac output syndrome. The PDA banding was performed urgently as a rescue measure in order to restore systemic flow while still maintaining some duct-dependent pulmonary blood flow. This approach resolved the circular shunting. Outcome was favorable in both the patients.

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