Interaction between pulmonary vasculature and the patent ductus arteriosus in very premature infants.
| Autor: | Hoffman JIE; Department of Pediatrics, University of California, San Francisco, CA, USA. |
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| Jazyk: | angličtina |
| Zdroj: | Journal of neonatal-perinatal medicine [J Neonatal Perinatal Med] 2021; Vol. 14 (2), pp. 159-161. |
| DOI: | 10.3233/NPM-190278 |
| Abstrakt: | Background: The benefits of closing the ductus arteriosus in very preterm infants have not been convincingly shown in numerous clinical trials. Because a large untreated ductus arteriosus can cause death from congestive heart failure in infants born at term, we need to explain why this might not occur in premature infants born at <28 weeks' gestation. Methods: Based on information in the literature, I have commented on the possible relationship between the pulmonary vasculature and the shunt through the patent ductus arteriosus. Results: Many of these infants have bronchopulmonary dysplasia, in which animal and human studies have shown a reduced number of capillaries and small pulmonary arteries as well as reduction in vascular endothelial growth factor (VEGF) and platelet endothelial cell adhesion molecule-1 (PECAM-1). Both of these import angiogenic factors. Some who do not have bronchopulmonary dysplasia may have a restricted pulmonary vascular bed. Conclusions: The increased pulmonary vascular resistance in very premature infants may restrict pulmonary blood flow even if the ductus is large, thus reducing the urgency for ductus closure. |
| Databáze: | MEDLINE |
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