Walther F J, Kim D H, Ebrahimi M, Siassi B
Department of Pediatrics, University of Southern California School of Medicine, Los Angeles.
Biol Neonate. 1989;56(3):121-8. doi: 10.1159/000243112.
High left ventricular output (LVO) values are associated with symptomatic left-to-right ductal shunting in preterm infants. However, LVO data prior to the occurrence of symptomatic patent ductus arteriosus (SPDA) are lacking. To determine whether serial measurements could predict a SPDA, we measured LVO from day 1 until day 10 with pulsed Doppler echocardiography in 25 preterm infants with birth weights of less than 1,250 g and hematocrits of more than 0.40. Eleven infants never developed patent ductus arteriosus symptoms and had LVO values within the normal range (190-310 ml/min/kg) with only minimal daily variations. The remaining 14 infants developed SPDA which required treatment with indomethacin, ductal ligation, or fluid restriction on days 2-5. From day 1 until day 5 their mean LVO values were significantly higher compared to the group without left-to-right ductal shunt and this increase was secondary to higher stroke volume values. An increase in LVO of more than 60 ml/min/kg consistently preceded SPDA by at least 24 h. Serial measurements of LVO using a single-pulsed Doppler approach can be used for early prediction of SPDA.
左心室高输出量（LVO）值与早产儿有症状的左向右导管分流有关。然而，在有症状的动脉导管未闭（SPDA）出现之前，缺乏LVO数据。为了确定连续测量是否可以预测SPDA，我们使用脉冲多普勒超声心动图对25例出生体重小于1250 g且血细胞比容大于0.40的早产儿从第1天到第10天测量LVO。11例婴儿从未出现动脉导管未闭症状，LVO值在正常范围内（190 - 310 ml/min/kg），每日变化极小。其余14例婴儿出现SPDA，需要在第2 - 5天用吲哚美辛、导管结扎或液体限制进行治疗。从第1天到第5天，他们的平均LVO值与无左向右导管分流的组相比显著更高，这种增加是由于更高的每搏输出量值所致。LVO增加超过60 ml/min/kg至少在SPDA出现前24小时持续存在。使用单脉冲多普勒方法连续测量LVO可用于SPDA的早期预测。
