Hemodynamic Instability after Patent Ductus Arteriosus Ligation in Very Low Birth Weight Infants.

La,  Kyong Suk; Lee,  Jang Hoon; Choi,  Byung Min; Han,  Heon Seok; Hong,  Young Sook; Lee,  Joo won

doi:2010.17.2.201

Neonatal Med > Volume 17(2); 2010 > Article

Original Article

Journal of the Korean Society of Neonatology 2010;17(2):201-206.
DOI: https://doi.org/10.5385/jksn.2010.17.2.201 Published online October 15, 2010.

Hemodynamic Instability after Patent Ductus Arteriosus Ligation in Very Low Birth Weight Infants.

Kyong Suk La, Jang Hoon Lee, Byung Min Choi, Heon Seok Han, Young Sook Hong, Joo won Lee

¹Department of Pediatrics, College of Medicine, Korea University, Seoul, Korea.
²Department of Pediatrics, College of Medicine, Chungbuk National University, Cheongju, Korea. neopedlee@gmail.com

Abstract

PURPOSE
Recently, after patent ductus arteriosus (PDA) ligation in preterm infants, unexplained hemodynamic instabilities are reported. To determine the incidence, risk factors and clinical manifestations of hemodynamic instability after PDA ligation in very low birth weight (VLBW) infants.
METHODS
This retrospective multicenter study enrolled 18 VLBW infants who underwent PDA ligation from January 2002 to February 2008. Hemodynamic instability defined as unexplained cardiopulmonary dysfunction with increased dependency on mechanical ventilation and decreased blood pressure.
RESULTS
The mean gestational age and birth weight (BW) of all infants were 27(+)6+/-1(+6) weeks and 951+/-245 g. Hemodynamic instability group (HI) included seven infants (39%) and hemodynamic stability group (HS) included 11 infants (61%). Compared to HS, HI had lower BW (1,033+/-285 g vs. 821+/-126 g, P=0.048) and weight on operation day (1,195+/-404 g vs. 893+/-151 g, P=0.042), longer hospital days (105+/-29 vs. 141+/-39, P=0.038), more severe bronchopulmonary dysplasia (BPD), (no/mild/moderate/severe, 2/5/2/2 vs. 0/1/2/4, P=0.038) and higher preoperative FiO2 (0.29+/-0.06 vs. 0.38+/-0.09, P=0.02). One case of mortality due to sepsis, which was not associated with ligation, was observed among HS.
CONCLUSION
The incidence of hemodynamic instability after PDA ligation in VLBW infants was 39%. Low BW, low weight on operation day and preoperative high FiO2 might be risk factors of hemodynamic instability after PDA ligation in VLBW infants. The hemodynamic instability could increase the severity of BPD and hospital days.

Key Words: Patent ductus arteriosus; Hemodynamics; Premature birth