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Aortic root blood flow increases after pancuronium in neonates with hyaline membrane disease
D T Costakos1, C E Blackwell, A N Krauss
1Department of Pediatrics, New York Hospital-Cornell Medical Center, NY 10021.
Insights
Muscle paralysis with pancuronium bromide significantly improved aortic root blood flow in preterm infants with hyaline membrane disease. This intervention enhanced circulation by increasing stroke volume and heart rate.
Area of Science:
- Neonatal physiology
- Cardiovascular research
- Respiratory medicine
Background:
- Hyaline membrane disease (HMD) is a common respiratory distress condition in preterm infants.
- Cardiovascular compromise can exacerbate HMD severity.
- Optimizing blood flow is crucial for preterm infant outcomes.
Purpose of the Study:
- To investigate the impact of induced muscle paralysis on aortic root blood flow.
- To assess the circulatory effects of pancuronium bromide in preterm infants with HMD.
Main Methods:
- Prospective, controlled trial with patients serving as their own controls.
- Noninvasive Doppler echocardiography to measure aortic root blood flow.
- Measurement before and after pancuronium bromide administration or ventilator changes.
Main Results:
- Mean aortic root blood flow significantly increased by 30% (p < .001).
- Stroke volume and heart rate also showed significant increases.
- These circulatory improvements were observed in ventilator-dependent preterm infants with HMD.
Conclusions:
- Pancuronium bromide administration demonstrated a direct beneficial effect on aortic root blood flow.
- The findings suggest a potential therapeutic role for pancuronium bromide in managing circulatory dysfunction in HMD.
- Further research is warranted to confirm these circulatory benefits.
Objective:
To determine the effects of muscle paralysis on aortic root blood flow in preterm infants with hyaline membrane disease.
Design:
Each patient served as his/her own control in a prospectively controlled trial.
Setting:
Neonatal ICU in a university hospital.
Patients:
Ten ventilator-dependent preterm infants weighing 800 to 2820 g, 0 to 8 days of age, with hyaline membrane disease and seven control patients.
Interventions:
Noninvasive measurement of aortic root blood flow by Doppler echocardiography 30 min before and 60 min after respiratory paralysis with 0.1 to 0.5 mg/kg of iv pancuronium, or following ventilator changes in control subjects.
Results:
Mean aortic root blood flow increased significantly (p less than .001), from 212 to 276 mL/min.kg, accompanied by significant increases in stroke volume and heart rate.
Conclusions:
Pancuronium bromide may have a direct beneficial effect on the circulation of preterm infants with hyaline membrane disease.