Abstract
Dramatic but transient improvements in oxygenation may be seen after surfactant therapy. An increase in patent ductus arteriosus (PDA) may be a complication of this treatment. To see if surfactant (curosurf, CSRF) increases left to right PDA shunting, plasma ANP levels were taken before and within 1 hour of CSRF. 12 infants, birthweights 0.27-3.10kg, gestational age 25-36 weeks, received 1-5 doses of CSRF each at 12 hour intervals. The median ANP level rose progressively for doses 1, 2 and 3 being 492, 955 and 2161pg/ml respectively. In infants without a PDA, the ANP did not change significantly with CSRF (median before 605, 825pg/ml after). But in those with a PDA, ANP rose significantly (median before 1672, 2716pg/ml after) (p<0.01, Wilcoxon ranked sum test).
The progressively rising AMP levels during treatment to the range previously reported for infants with a PDA(1) suggest increasing left atrial distension which may be the result of left to right shunting through a PDA. The rise in ANP levels after CSRF may be the result of increased PDA shunting due to a fall in pulmonary artery pressure. CSRF treatment appears to have significant effects on haemodynatnics in preterm infants.
(1) Weir et al. Pediatr Res 1990;28:292
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Weir, F., Littleton, P., Carter, N. et al. 62 ATRIAL NATRIURETIC PEPTIDE (ANP) IN PRETERM INFANTS WITH RESPIRATORY DISTRESS SYNDROME(RDS) TREATED WITH SURFACTANT. Pediatr Res 30, 638 (1991). https://doi.org/10.1203/00006450-199112000-00092
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DOI: https://doi.org/10.1203/00006450-199112000-00092