Bancalari Eduardo, Claure Nelson, Gonzalez Alvaro
Division of Newborn Medicine, Department of Pediatrics, University Miami Miller School of Medicine, Miami, Florida 33101, USA.
Biol Neonate. 2005;88(3):192-201. doi: 10.1159/000087582.
A persistent ductus arteriosus is a common event in preterm infants. The systemic-to-pulmonary shunting that occurs as the pulmonary vascular resistance decreases after birth can have significant cardiovascular and respiratory consequences. Acute pulmonary effects include pulmonary edema and hemorrhage, worsened lung mechanics and deterioration in gas exchange with hypoxemia and hypercapnia. The increased pulmonary blood flow can also produce damage to the capillary endothelium and trigger an inflammatory cascade. This, plus the need for longer and more aggressive mechanical ventilation, can explain the association between patent ductus arteriosus and an increased risk for bronchopulmonary dysplasia in extremely premature infants.
动脉导管未闭在早产儿中很常见。出生后随着肺血管阻力降低而发生的体循环至肺循环分流可产生重大的心血管和呼吸后果。急性肺部影响包括肺水肿和出血、肺力学恶化以及气体交换变差并伴有低氧血症和高碳酸血症。肺血流量增加还可损害毛细血管内皮并引发炎症级联反应。这一点，再加上需要更长时间和更积极的机械通气，可解释动脉导管未闭与极早产儿支气管肺发育不良风险增加之间的关联。
