NEONATAL PULMONARY ISCHEMIA Part I: Clinical and Physiological Studies

摘要: We made detailed observations of the cardiopulmonary manifestations respiratory distress syndrome in 27 infants. In most respects these confirmed reported by other investigators. Expiratory complaint was a major feature disease, and its effects on cardiac input work breathing have been discussed. It may result reflexes initiated pulmonary vessels when they were strongly stimulated to constrict. Infants with severe showed systemic hypotension, cutaneous vasoconstriction, oliguria, ileus. They usually had slightly increased minute volume. Lung compliance volume ratio lung decreased, but resistance normal. Apparent physiological deadspace greatly elevated, apparent alveolar ventilation therefore decreased. Arterial oxygen tension below predicted values, there moderate very large fractional right-to-left shunt which appeared occur principally through foramen ovale lesser extent ductus arteriosus. There both metabolic acidosis. Effective blood flow often strikingly reduced, as input, roughly estimated from effective shunt. Administration dipalmitoyl lecithin an aerosol followed increase compliance, occurred even those infants who died. Infusion acetylcholine caused rapid, accompanied marked rise decrease shunt, carbon dioxide elimination, alleviation expiratory complaint, responsiveness motor activity. conclude that vasoconstriction ischemia because low right ventricular pressure normal rapidly drop pressure. Pulmonary present early disease. also flow, especially renal, mesenteric, vascular beds, administration brought about more distribution flow. Because whose gas transfer not improved died, infusion prompt improvement transfer, clinical status without simultaneous or ventilation, we certain beds presented greater functional difficulty than did atelectasis hyaline membranes. this study ACh used demonstrate mechanism, and, our opinion, firm recommendation for use (or vasodilator) must await convincing test carried out proper experimental design sufficiently number subjects.