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

S Noori¹, P McNamara², A Jain³, P M Lavoie⁴, A Wickremasinghe⁵, T A Merritt⁶, T Solomon⁶, K Sekar⁷, J T Attridge⁸, J R Swanson⁸, M Gillam-Krakauer⁹, J Reese⁹, B B Poindexter¹⁰, M Brook⁵, R J Auchus¹¹, R I Clyman⁵; PDA Ligation/Hypotension Trial Investigators

Collaborators, Affiliations

Collaborators

Affiliations

¹ 1] Department of Pediatrics, Children's Hospital of Los Angeles, University of South California, Los Angeles, CA, USA [2] Department of Pediatrics, University of Oklahoma, Oklahoma, OK, USA.
² Department of Pediatrics, Hospital for Sick Children, Toronto, ON, Canada.
³ 1] Department of Pediatrics, Hospital for Sick Children, Toronto, ON, Canada [2] Department of Pediatrics, Mount Sinai Hospital, University of Toronto, ON, Canada.
⁴ Department of Pediatrics Children's & Women's Health Centre of British Columbia, Vancouver, BC, Canada.
⁵ Department of Pediatrics, Cardiovascular Research Institute, University of California San Francisco, San Francisco, CA, USA.
⁶ Department of Pediatrics, Loma Linda University, Loma Linda, CA, USA.
⁷ Department of Pediatrics, University of Oklahoma, Oklahoma, OK, USA.
⁸ Department of Pediatrics, University of Virginia, Charlottesville, VA, USA.
⁹ Department of Pediatrics, Vanderbilt University, Nashville, TN, USA.
¹⁰ Department of Pediatrics, Indiana University, Indianapolis, IN, USA.
¹¹ Department of Medicine, University of Michigan, Ann Arbor, MI, USA.

PMID: 25118721
PMCID: PMC4310792
DOI: 10.1038/jp.2014.151

Clinical Trial

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

S Noori et al. J Perinatol. 2015 Feb.

. 2015 Feb;35(2):123-7.

doi: 10.1038/jp.2014.151. Epub 2014 Aug 14.

Authors

Collaborators

Affiliations

¹ 1] Department of Pediatrics, Children's Hospital of Los Angeles, University of South California, Los Angeles, CA, USA [2] Department of Pediatrics, University of Oklahoma, Oklahoma, OK, USA.
² Department of Pediatrics, Hospital for Sick Children, Toronto, ON, Canada.
³ 1] Department of Pediatrics, Hospital for Sick Children, Toronto, ON, Canada [2] Department of Pediatrics, Mount Sinai Hospital, University of Toronto, ON, Canada.
⁴ Department of Pediatrics Children's & Women's Health Centre of British Columbia, Vancouver, BC, Canada.
⁵ Department of Pediatrics, Cardiovascular Research Institute, University of California San Francisco, San Francisco, CA, USA.
⁶ Department of Pediatrics, Loma Linda University, Loma Linda, CA, USA.
⁷ Department of Pediatrics, University of Oklahoma, Oklahoma, OK, USA.
⁸ Department of Pediatrics, University of Virginia, Charlottesville, VA, USA.
⁹ Department of Pediatrics, Vanderbilt University, Nashville, TN, USA.
¹⁰ Department of Pediatrics, Indiana University, Indianapolis, IN, USA.
¹¹ Department of Medicine, University of Michigan, Ann Arbor, MI, USA.

PMID: 25118721
PMCID: PMC4310792
DOI: 10.1038/jp.2014.151

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(-1)min(-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.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest:

The authors have no conflict of interest.

References

1. Moin F, Kennedy KA, Moya FR. Risk factors predicting vasopressor use after patent ductus arteriosus ligation. Am J Perinatol. 2003;20:313–320. - PubMed
1. Harting MT, Blakely ML, Cox CS, Jr, Lantin-Hermoso R, Andrassy RJ, Lally KP. Acute hemodynamic decompensation following patent ductus arteriosus ligation in premature infants. J Invest Surg. 2008;21:133–138. - PubMed
1. Teixeira LS, Shivananda SP, Stephens D, Van Arsdell G, McNamara PJ. Postoperative cardiorespiratory instability following ligation of the preterm ductus arteriosus is related to early need for intervention. J Perinatol. 2008;28:803–810. - PubMed
1. Clyman RI, Wickremasinghe A, Merritt TA, Solomon T, McNamara P, Jain A, Singh J, Chu A, Noori S, Sekar K, Lavoie PM, Attridge JT, JR S, Gillam-Krakauer M, Reese J, DeMauro S, Poindexter B, Aucott S, Satpute M, Fernandez E, Auchus RJ. Hypotension following patent ductus arteriosus ligation: The role of adrenal hormones. J Pediatr. 2014;164:1449–1455. - PMC - PubMed
1. Noori S, Friedlich P, Seri I, Wong P. Changes in myocardial function and hemodynamics after ligation of the ductus arteriosus in preterm infants. J Pediatr. 2007;150:597–602. - PubMed

Publication types

Actions
Actions
Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

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

Collaborators

Affiliations

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

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

References

Publication types

MeSH terms

Substances

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical