Lippmann M, Nelson R J, Emmanouilides G C, Diskin J, Thibeault D W
Br J Anaesth. 1976 Apr;48(4):365-9. doi: 10.1093/bja/48.4.365.
Twenty-four neonates at 25-34 weeks' gestation with a weight range of 570-1530 g underwent ligation of patent ductus arteriosus (PDA). The infants had mild to severe respiratory distress syndrome at birth and later developed signs of heart failure as a result of left-to-right shunting through a PDA. Surgical closure of the PDA was performed within 2-31 days after birth. In the period before operation the heart rate was monitored constantly and the arterial blood-gases were assessed frequently. The trachea was intubated and respiration was controlled with a ventilator. Surgery was performed under controlled ventilation and no anaesthesia was used. Care was taken not to overventilate the lungs. Nine infants died. Death was associated with higher peak inspiratory ventilator pressures at the time of operation and with complications occurring during or after the operation. The most common complication was tension pneumomediastinum which appears to be related to excessive ventilator pressures during surgery.
24例孕25 - 34周、体重在570 - 1530克之间的新生儿接受了动脉导管未闭（PDA）结扎术。这些婴儿出生时患有轻度至重度呼吸窘迫综合征，后来由于通过PDA的左向右分流而出现心力衰竭迹象。PDA手术闭合在出生后2 - 31天内进行。术前持续监测心率并频繁评估动脉血气。气管插管并用呼吸机控制呼吸。手术在控制通气下进行，未使用麻醉。注意避免肺过度通气。9例婴儿死亡。死亡与手术时较高的吸气峰呼吸机压力以及手术期间或术后出现的并发症有关。最常见的并发症是张力性纵隔气肿，这似乎与手术期间过高的呼吸机压力有关。
