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

PDA Ligation/Hypotension Trial Investigators

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

OBJECTIVE: We performed a multicenter study of preterm infants, who were about to undergo patent ductus arteriosus ligation, to determine whether echocardiographic indices of impaired myocardial performance were associated with subsequent development of catecholamine-resistant hypotension following ligation. STUDY DESIGN: A standardized treatment approach for hypotension was followed at each center. Infants were considered to have catecholamine-resistant hypotension if their dopamine infusion was >15 μg kg-1min-1. Echocardiograms and cortisol measurements were obtained between 6 and 14 h after the ligation (prior to the presence of catecholamine-resistant hypotension). RESULT: Forty-five infants were enrolled, 10 received catecholamines (6 were catecholamine-responsive and 4 developed catecholamine-resistant hypotension). Catecholamine-resistant hypotension was not associated with decreased preload, shortening fraction or ventricular output. Infants with catecholamine-resistant hypotension had significantly lower levels of systemic vascular resistance and postoperative cortisol concentration. CONCLUSION: We speculate that low cortisol levels and impaired vascular tone may have a more important role than impaired cardiac performance in post-ligation catecholamine-resistant hypotension.

Original languageEnglish (US)
Pages (from-to)123-127
Number of pages5
JournalJournal of Perinatology
Volume35
Issue number2
DOIs
StatePublished - Mar 2 2015

Fingerprint

Patent Ductus Arteriosus
Hypotension
Catecholamines
Ligation
Hydrocortisone
Premature Infants
Vascular Resistance
Multicenter Studies
Blood Vessels
Dopamine

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

Catecholamine-resistant hypotension and myocardial performance following patent ductus arteriosus ligation. / PDA Ligation/Hypotension Trial Investigators.

In: Journal of Perinatology, Vol. 35, No. 2, 02.03.2015, p. 123-127.

Research output: Contribution to journalArticle

Noori, S. ; McNamara, P. ; Jain, A. ; Lavoie, P. M. ; Wickremasinghe, A. ; Merritt, T. A. ; Solomon, T. ; Sekar, K. ; Attridge, J. T. ; Swanson, J. R. ; Gillam-Krakauer, M. ; Reese, J. ; Poindexter, B. B. ; Brook, M. ; Auchus, R. J. ; Clyman, R. I. ; Matthews, Susan ; Chomic, Robert ; Brown, Stephen C. ; Kuhn, Michael ; El-Khuffash, Afif ; Luc, Jenny ; McCoy, Michael ; Corff, Karen ; Claydon, Jennifer ; Lusney, Nadine ; Finlay, Kristi ; Blackman, Amy E. ; Law-Beller, Amy ; Wilson, Leslie Dawn. / Catecholamine-resistant hypotension and myocardial performance following patent ductus arteriosus ligation. In: Journal of Perinatology. 2015 ; Vol. 35, No. 2. pp. 123-127.
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abstract = "OBJECTIVE: We performed a multicenter study of preterm infants, who were about to undergo patent ductus arteriosus ligation, to determine whether echocardiographic indices of impaired myocardial performance were associated with subsequent development of catecholamine-resistant hypotension following ligation. STUDY DESIGN: A standardized treatment approach for hypotension was followed at each center. Infants were considered to have catecholamine-resistant hypotension if their dopamine infusion was >15 μg kg-1min-1. Echocardiograms and cortisol measurements were obtained between 6 and 14 h after the ligation (prior to the presence of catecholamine-resistant hypotension). RESULT: Forty-five infants were enrolled, 10 received catecholamines (6 were catecholamine-responsive and 4 developed catecholamine-resistant hypotension). Catecholamine-resistant hypotension was not associated with decreased preload, shortening fraction or ventricular output. Infants with catecholamine-resistant hypotension had significantly lower levels of systemic vascular resistance and postoperative cortisol concentration. CONCLUSION: We speculate that low cortisol levels and impaired vascular tone may have a more important role than impaired cardiac performance in post-ligation catecholamine-resistant hypotension.",
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AU - Noori, S.

AU - McNamara, P.

AU - Jain, A.

AU - Lavoie, P. M.

AU - Wickremasinghe, A.

AU - Merritt, T. A.

AU - Solomon, T.

AU - Sekar, K.

AU - Attridge, J. T.

AU - Swanson, J. R.

AU - Gillam-Krakauer, M.

AU - Reese, J.

AU - Poindexter, B. B.

AU - Brook, M.

AU - Auchus, R. J.

AU - Clyman, R. I.

AU - Matthews, Susan

AU - Chomic, Robert

AU - Brown, Stephen C.

AU - Kuhn, Michael

AU - El-Khuffash, Afif

AU - Luc, Jenny

AU - McCoy, Michael

AU - Corff, Karen

AU - Claydon, Jennifer

AU - Lusney, Nadine

AU - Finlay, Kristi

AU - Blackman, Amy E.

AU - Law-Beller, Amy

AU - Wilson, Leslie Dawn

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N2 - OBJECTIVE: We performed a multicenter study of preterm infants, who were about to undergo patent ductus arteriosus ligation, to determine whether echocardiographic indices of impaired myocardial performance were associated with subsequent development of catecholamine-resistant hypotension following ligation. STUDY DESIGN: A standardized treatment approach for hypotension was followed at each center. Infants were considered to have catecholamine-resistant hypotension if their dopamine infusion was >15 μg kg-1min-1. Echocardiograms and cortisol measurements were obtained between 6 and 14 h after the ligation (prior to the presence of catecholamine-resistant hypotension). RESULT: Forty-five infants were enrolled, 10 received catecholamines (6 were catecholamine-responsive and 4 developed catecholamine-resistant hypotension). Catecholamine-resistant hypotension was not associated with decreased preload, shortening fraction or ventricular output. Infants with catecholamine-resistant hypotension had significantly lower levels of systemic vascular resistance and postoperative cortisol concentration. CONCLUSION: We speculate that low cortisol levels and impaired vascular tone may have a more important role than impaired cardiac performance in post-ligation catecholamine-resistant hypotension.

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