Malone T A, Stonestreet B S, Goddard M, Oh W
Department of Pediatrics, Women & Infants' Hospital, Rhode Island, Providence 02905.
Am J Perinatol. 1990 Apr;7(2):184-8. doi: 10.1055/s-2007-999477.
Patent ductus arteriosus (PDA) is a common form of congenital heart disease in full-term infants. To investigate the morbidities associated with a left to right PDA shunt, we produced a PDA in six full-term newborn piglets (less than 36 hours old) by bathing the ductus arteriosus with prostaglandin E (PGE) and infiltrating it with formalin. In five age-matched piglets, the ductus arteriosus was ligated to serve as controls. Microsphere determinations of left ventricular output (LVO) and regional blood flow (Q) were made on three consecutive days. We produced left to right shunts of 36 to 47% (mean) in the experimental piglets. The experimental piglets had a 22 to 36% increase in LVO with a one- to twofold reduction in percentage of LVO to the kidneys and carcass (p less than 0.05). Although percentage of LVO to the gastrointestinal tract was reduced (p less than 0.05), no reduction of absolute Q to the gastrointestinal tract was observed. Brain and heart Q were similar in both groups. We conclude that significant hemodynamic changes result from left to right shunting in the full-term newborn piglet with PDA. These hemodynamic changes, such as reduction in renal blood flow, are relevant information that will help explain the morbidities observed in infants with a hemodynamically significant PDA with a left to right shunt.
动脉导管未闭（PDA）是足月儿常见的先天性心脏病形式。为了研究与动脉导管未闭左向右分流相关的发病率，我们通过用前列腺素E（PGE）浸泡动脉导管并用福尔马林浸润，在六只足月新生仔猪（小于36小时龄）中制造了动脉导管未闭。在五只年龄匹配的仔猪中，结扎动脉导管作为对照。连续三天对左心室输出量（LVO）和局部血流（Q）进行微球测定。我们在实验仔猪中产生了36%至47%（平均）的左向右分流。实验仔猪的LVO增加了22%至36%，流向肾脏和躯体的LVO百分比降低了一至两倍（p<0.05）。尽管流向胃肠道的LVO百分比降低了（p<0.05），但未观察到流向胃肠道的绝对Q值降低。两组的脑和心脏Q值相似。我们得出结论，足月新生仔猪动脉导管未闭左向右分流会导致显著的血流动力学变化。这些血流动力学变化，如肾血流量减少，是有助于解释具有血流动力学意义的动脉导管未闭左向右分流婴儿所观察到的发病率的相关信息。
