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

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TitleCatecholamine-resistant hypotension and myocardial performance following patent ductus arteriosus ligation.
Publication TypeJournal Article
Year of Publication2015
AuthorsNoori S, McNamara P, Jain A, Lavoie PM, Wickremasinghe A, Merritt TA, Solomon T, Sekar K, Attridge JT, Swanson JR, Gillam-Krakauer M, Reese J, Poindexter BB, Brook M, Auchus RJ, Clyman RI
Corporate AuthorsPDA Ligation/Hypotension Trial Investigators
JournalJ Perinatol
Volume35
Issue2
Pagination123-7
Date Published2015 Feb
ISSN1476-5543
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.

DOI10.1038/jp.2014.151
Alternate JournalJ Perinatol
PubMed ID25118721
PubMed Central IDPMC4310792
Grant ListDK089503 / DK / NIDDK NIH HHS / United States
HL109199 / HL / NHLBI NIH HHS / United States
P30 DK089503 / DK / NIDDK NIH HHS / United States
U24 DK097153 / DK / NIDDK NIH HHS / United States
U24DK097153 / DK / NIDDK NIH HHS / United States
UL1 RR024975 / RR / NCRR NIH HHS / United States
UL1 TR000004 / TR / NCATS NIH HHS / United States
UL1 TR000004 / TR / NCATS NIH HHS / United States
UL1 TR000445 / TR / NCATS NIH HHS / United States
UL1 TR000445-06 / TR / NCATS NIH HHS / United States