Catecholamine-resistant hypotension and myocardial performance following patent ductus arteriosus ligation.
Lavoie, P M
Merritt, T A
Attridge, J T
Swanson, J R
Poindexter, B B
Auchus, R J
Clyman, R I
Affiliation1] Department of Pediatrics, Children's Hospital of Los Angeles, University of South California, Los Angeles, CA, USA  Department of Pediatrics, University of Oklahoma, Oklahoma, OK, USA.
Local subject classificationHEART
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CitationNoori, S. et al., 2014. Catecholamine-resistant hypotension and myocardial performance following patent ductus arteriosus ligation. Journal of Perinatology, 2014 [ Epub 2014 Aug 14]
JournalJournal of Perinatology : official journal of the California Perinatal Association
AbstractObjective:We performed a multicenter study of preterm infants, who were about to undergo patent ductus arteriosus ligation, to determine whether echocardiographic indices of impaired myocardial performance were associated with subsequent development of catecholamine-resistant hypotension following ligation.Study Design:A standardized treatment approach for hypotension was followed at each center. Infants were considered to have catecholamine-resistant hypotension if their dopamine infusion was >15 μg kg(-1)min(-1). Echocardiograms and cortisol measurements were obtained between 6 and 14 h after the ligation (prior to the presence of catecholamine-resistant hypotension).Result:Forty-five infants were enrolled, 10 received catecholamines (6 were catecholamine-responsive and 4 developed catecholamine-resistant hypotension). Catecholamine-resistant hypotension was not associated with decreased preload, shortening fraction or ventricular output. Infants with catecholamine-resistant hypotension had significantly lower levels of systemic vascular resistance and postoperative cortisol concentration.Conclusion:We speculate that low cortisol levels and impaired vascular tone may have a more important role than impaired cardiac performance in post-ligation catecholamine-resistant hypotension.Journal of Perinatology advance online publication, 14 August 2014; doi:10.1038/jp.2014.151.