Closure…

This issue features two articles on the ductus arteriosus (DA). In the first, Chen and colleagues suggest a novel physiological role for isoprostanes during postnatal vascular transition. The results of their experiments provide evidence that oxidative stress acts on membrane lipids to produce vasoactive mediators that affect DA closure and patency.

See Isoprostanes as physiological mediators of transition to newborn life: novel mechanisms regulating patency of the term and preterm ductus arteriosus

…and Patency

The second article on DA in this issue focuses on patent ductus arteriosus (PDA), a common, life-threatening complication in preterm infants. Because thromboxane A2 (TXA2) induces vascular contraction via TXA2 receptor (TP), Yokota and colleagues hypothesized that TP stimulation promotes DA closure. In their study, low-dose TP stimulation in newborn rats appeared to constrict the DA with minimal adverse effects. This mechanism could be the basis of vasoconstrictors for PDA treatment.

See Low-dose thromboxane A2 receptor stimulation promotes closure of the rat ductus arteriosus with minimal adverse effects

Pulmonary inflammation

Nathe and coinvestigators characterized innate immune activation in tracheal aspirates (TAs) of mechanically ventilated newborns. Correlation of endotoxin with TA inflammatory responses suggests endotoxin bioactivity and the possibility that endotoxin antagonists can mitigate pulmonary inflammation and its sequelae.

See Innate immune activation in neonatal tracheal aspirates suggests endotoxin-driven inflammation

Neonatal hyperbilirubinemia

Neonatal hyperbilirubinemia is caused by increased bilirubin production and/or decreased bilirubin elimination. Although phototherapy safely and effectively reduces bilirubin levels, recent evidence suggests that it has adverse effects and therefore that alternative treatments are warranted. Schulz et al. investigated possible photosensitizing effects of chromium mesoporphyrin and zinc deuteroporphyrin bis-glycol (ZnBG). Low doses of ZnBG appeared to retain maximal heme oxygenase inhibitory potency without photosensitizing effects and thus might be useful in treating neonatal hyperbilirubinemia.

See Effect of light exposure on metalloporphyrin-treated newborn mice

Optimizing ventilation

Neurally adjusted ventilatory assist (NAVA) is a mode of ventilation controlled by the electrical activity of the diaphragm. Bordessoule and coinvestigators evaluated patient–ventilator interaction in infants during NAVA as compared with infants undergoing conventional ventilation. NAVA was associated with improved patient–ventilator interaction and delivered adequate ventilation with variable pressure.

See Neurally adjusted ventilatory assist improves patient-ventilator interaction in infants as compared with conventional ventilation