Respiratory and cardiovascular morbidity in the first 48 hours post surgical ligation of the patent ductus arteriosus

J. V. Francis, S. Padmanabhan, L. Jaques, J. Courtot, A. Sehgal

Research output: Contribution to journalArticleResearchpeer-review

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 languageEnglish
Pages (from-to)21-26
Number of pages6
JournalJournal of Neonatal-Perinatal Medicine
Volume4
Issue number1
DOIs
Publication statusPublished - 2011

Keywords

  • Cardiorespiratory morbidity
  • duct ligation
  • Haemodynamically Significant Ductus Arteriosus

Cite this

@article{9b8104a2408c42d297095564d46dae06,
title = "Respiratory and cardiovascular morbidity in the first 48 hours post surgical ligation of the patent ductus arteriosus",
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.",
keywords = "Cardiorespiratory morbidity, duct ligation, Haemodynamically Significant Ductus Arteriosus",
author = "Francis, {J. V.} and S. Padmanabhan and L. Jaques and J. Courtot and A. Sehgal",
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pages = "21--26",
journal = "Journal of Neonatal and Perinatal Medicine",
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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 journalArticleResearchpeer-review

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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

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DO - 10.3233/NPM-2011-2724

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JF - Journal of Neonatal and Perinatal Medicine

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