Abstract
Background: Ligation of a patent ductus arteriosus could be associated with severe cardiorespiratory compromise in preterm infants. There is limited data on the incidence, profile and temporal profile of post-operative morbidity. Objective: To assess the incidence, profile and temporal occurrence of cardiovascular and respiratory decompensation during the first 48 hours of postoperative period. Method: Retrospective analysis of the cohort over last seven years (2002-2008) was done and charts reviewed to record demographics and haemodynamic/ventilatory indices. Respiratory decompensation was defined a priori as increase in Fractional inspired oxygen by 0.2, Mean airway pressure by 2 cm H2O, increase in Respiratory Severity Score by 50% or increase in Ventilation Index by 50%. Cardiovascular decompensation was defined as systolic blood pressure <2 standard deviation, addition of inotrope, increase in dosage of previously started inotrope by 5 micrograms/kg/min or need for hydrocortisone. Data was plotted under 4 time epochs; 0-6, 6-12, 12-24 and 24-48 hours after surgical intervention. Results: Forty eight infants underwent duct ligation during the period. Mean gestational age and birthweight were 26.1 ± 1.3 weeks and 788 ± 181 g respectively. Respiratory decompensation was seen in 14 (29%) babies (increase in Mean airway pressure and Fractional inspired oxygen each) and 23 (48%) babies (increase in Respiratory Severity Score by 50%). Cardiovascular decompensation was seen in 14 (29%) babies (low systolic blood pressure), and 9 (19%) (addition or increased dosage of inotropes or hydrocortisone). Conclusions: Postoperative period after surgical duct ligation is oftentimes complicated by cardiorespiratory instability. Its knowledge could improve care in critically sick infants.
| Original language | English |
|---|---|
| Pages (from-to) | 21-26 |
| Number of pages | 6 |
| Journal | Journal of Neonatal-Perinatal Medicine |
| Volume | 4 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 2011 |
Keywords
- Cardiorespiratory morbidity
- duct ligation
- Haemodynamically Significant Ductus Arteriosus
Cite this
}
Respiratory and cardiovascular morbidity in the first 48 hours post surgical ligation of the patent ductus arteriosus. / Francis, J. V.; Padmanabhan, S.; Jaques, L.; Courtot, J.; Sehgal, A.
In: Journal of Neonatal-Perinatal Medicine, Vol. 4, No. 1, 2011, p. 21-26.Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - Respiratory and cardiovascular morbidity in the first 48 hours post surgical ligation of the patent ductus arteriosus
AU - Francis, J. V.
AU - Padmanabhan, S.
AU - Jaques, L.
AU - Courtot, J.
AU - Sehgal, A.
PY - 2011
Y1 - 2011
N2 - Background: Ligation of a patent ductus arteriosus could be associated with severe cardiorespiratory compromise in preterm infants. There is limited data on the incidence, profile and temporal profile of post-operative morbidity. Objective: To assess the incidence, profile and temporal occurrence of cardiovascular and respiratory decompensation during the first 48 hours of postoperative period. Method: Retrospective analysis of the cohort over last seven years (2002-2008) was done and charts reviewed to record demographics and haemodynamic/ventilatory indices. Respiratory decompensation was defined a priori as increase in Fractional inspired oxygen by 0.2, Mean airway pressure by 2 cm H2O, increase in Respiratory Severity Score by 50% or increase in Ventilation Index by 50%. Cardiovascular decompensation was defined as systolic blood pressure <2 standard deviation, addition of inotrope, increase in dosage of previously started inotrope by 5 micrograms/kg/min or need for hydrocortisone. Data was plotted under 4 time epochs; 0-6, 6-12, 12-24 and 24-48 hours after surgical intervention. Results: Forty eight infants underwent duct ligation during the period. Mean gestational age and birthweight were 26.1 ± 1.3 weeks and 788 ± 181 g respectively. Respiratory decompensation was seen in 14 (29%) babies (increase in Mean airway pressure and Fractional inspired oxygen each) and 23 (48%) babies (increase in Respiratory Severity Score by 50%). Cardiovascular decompensation was seen in 14 (29%) babies (low systolic blood pressure), and 9 (19%) (addition or increased dosage of inotropes or hydrocortisone). Conclusions: Postoperative period after surgical duct ligation is oftentimes complicated by cardiorespiratory instability. Its knowledge could improve care in critically sick infants.
AB - Background: Ligation of a patent ductus arteriosus could be associated with severe cardiorespiratory compromise in preterm infants. There is limited data on the incidence, profile and temporal profile of post-operative morbidity. Objective: To assess the incidence, profile and temporal occurrence of cardiovascular and respiratory decompensation during the first 48 hours of postoperative period. Method: Retrospective analysis of the cohort over last seven years (2002-2008) was done and charts reviewed to record demographics and haemodynamic/ventilatory indices. Respiratory decompensation was defined a priori as increase in Fractional inspired oxygen by 0.2, Mean airway pressure by 2 cm H2O, increase in Respiratory Severity Score by 50% or increase in Ventilation Index by 50%. Cardiovascular decompensation was defined as systolic blood pressure <2 standard deviation, addition of inotrope, increase in dosage of previously started inotrope by 5 micrograms/kg/min or need for hydrocortisone. Data was plotted under 4 time epochs; 0-6, 6-12, 12-24 and 24-48 hours after surgical intervention. Results: Forty eight infants underwent duct ligation during the period. Mean gestational age and birthweight were 26.1 ± 1.3 weeks and 788 ± 181 g respectively. Respiratory decompensation was seen in 14 (29%) babies (increase in Mean airway pressure and Fractional inspired oxygen each) and 23 (48%) babies (increase in Respiratory Severity Score by 50%). Cardiovascular decompensation was seen in 14 (29%) babies (low systolic blood pressure), and 9 (19%) (addition or increased dosage of inotropes or hydrocortisone). Conclusions: Postoperative period after surgical duct ligation is oftentimes complicated by cardiorespiratory instability. Its knowledge could improve care in critically sick infants.
KW - Cardiorespiratory morbidity
KW - duct ligation
KW - Haemodynamically Significant Ductus Arteriosus
UR - http://www.scopus.com/inward/record.url?scp=79953236421&partnerID=8YFLogxK
U2 - 10.3233/NPM-2011-2724
DO - 10.3233/NPM-2011-2724
M3 - Article
VL - 4
SP - 21
EP - 26
JO - Journal of Neonatal and Perinatal Medicine
JF - Journal of Neonatal and Perinatal Medicine
SN - 1934-5798
IS - 1
ER -