Plasma 6-keto prostaglandin F1α and thromboxane B2 in sick preterm neonates

doi:10.1016/0262-1746(85)90017-4

Prostaglandins, Leukotrienes and Medicine

Volume 18, Issue 2, May 1985, Pages 163-181

Prostaglandins, Leuk...

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Abstract

To determined if vascular abnormalities in preterm neonates might be related to vasoactive prostaglandins, stable prostacyclin(6-KPGF_1α)andthromboxaneA2(TxB₂) metabolites in arterial blood were measured at < 6 hours after birth and at 24, 48, and 72 hours using a radioimmunoassay. Neonates of <32 weeks gestation (N=26) were diagnosed as having either the idiopathic respiratory distress syndrome (IRDS, N=15) or pulmonary edema (PE, N=11), and were also grouped according to the presence or absence of intracranial hemorrhage (ICH, N=11) or patent ductus arteriosus (PDA, N=10). Initial plasma 6-KPGFla was greater in neonates with ICH (0.23 ± 0.04 ng/ml, mean + SE) than without ICH (0.11 ± 0.04, p < 0.05). Neonates with both ICH and IRDS (N=8)had significantly elevated TxB2 at all sampling times compared to neonates with IRDS and no ICH (N=7). Both TxB2 and 6-KPGFla increased with time in those with major ICH. Among neonates without ICH, 7 with IRDS had higher initial 6-KPGFla (0.19 + 0.07 ng/ml) and lower TxB2(0.15 + 0.04 ng/ml) than 8 with PE (0.04 +0.01 and 0.37 + 0.09 ng/ml, respectively).The initial 6-KPGF_lα (0.024 + 0.003 ng/ml), measured in neonates with PE and without PDA or ICH (N=6), was significantly less than the corresponding value in the other neonates (0.201 + 0.036 ng/ml) (N=20).

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Patent ductus arteriosus in preterm infants born at 23–24 weeks' gestation: Should we pay more attention?
2019, Early Human Development
Citation Excerpt :
We speculate that pPROM might indirectly contribute to the development of PDA by favoring the onset of perinatal infection. In fact, it has been demonstrated that infants with infection and PDA have high levels of the vasodilator 6-keto-PGF1α [20] which can explain the association between infection and PDA outcome by increasing the risk of ductal reopening and closure failure [21,22]. However, further studies are required to confirm this correlation.
Infants born at 23–24 weeks' gestation have the highest risk of developing a hemodynamically significant patent ductus arteriosus (hsPDA), that is refractory to pharmacological closure requiring surgical ligation. Thus, these patients might have the greatest benefits from hsPDA closure, although previous studies on PDA closure were not focused on this population.
To compare the occurrence of hsPDA, failure rate of the first course of ibuprofen in closing hsPDA, and need of surgical closure in infants born at 23⁺⁰–24⁺⁶ weeks' gestation to those in infants born at 25⁺⁰–28⁺⁶ weeks' gestation.
This is a retrospective multicenter study including infants born at 23⁺⁰–28⁺⁶ weeks of gestation admitted to the neonatal care units from January 2013 to December 2017. All infants underwent echocardiographical assessment for hsPDA diagnosis and eventually pharmacological treatment, and surgical closure.
We studied a total of 842 infants of which 562 (67%) developed a PDA. Among those with PDA, 511 (91%) received a pharmacological treatment for a hsPDA. We found that a hsPDA occurred in 70% (106/151) of infants born at 23–24 weeks and in 59% (405/691) of infants born at 25–28 weeks of gestation (P < 0.001). Failure of closure with the first-treatment cycle (69 vs. 40%; P < 0.001) and need of surgical closure (19 vs 10%) were more frequent (P < 0.011) in infants born at 23–24 than 25–28 gestational weeks. Paracetamol vs. ibuprofen treatment and gestational age of 23–24 versus 25–28 weeks increased closure failure, while less severe RDS and maternal clinical chorioamnionitis decreased it.
Among extremely preterm infants, infants born at 23–24 weeks of gestation have the highest risk of developing a hsPDA refractory to pharmacological treatment requiring surgical closure. Our findings support the need of individualized more careful strategies for hsPDA management in this special population.
Acute Effects and Long-Term Consequences
2018, The Newborn Lung: Neonatology Questions and Controversies, Third Edition
The ductus arteriosus plays a vital role in fetal life but failure to constrict and close postnatally, particularly in a premature infant, can result in systemic to pulmonary shunting. As a result of this shunting, a significant patent ductus arteriosus (PDA) can have both systemic (reduced systemic blood flow) and pulmonary (increased pulmonary blood flow) consequences and potential for lung injury. Despite the experimental and epidemiologic evidence supporting the role of the PDA in the pathogenesis of chronic lung injury, there are scarce data from more recent prospective clinical trials to confirm this association or demonstrate that treatment of the PDA has any effect on chronic lung injury. The need for treatment of the PDA is increasingly controversial because of a high rate of spontaneous closure, only moderate efficacy of the treatment options, and a risk of adverse effects. Both medical and surgical PDA treatment options are associated with lung injury. Until further evidence becomes available, the decision on management of PDA must balance the consequences of ductal patency that are closely related to its hemodynamic significance, versus the side effects of the interventions to close it. More data are needed to define the impact of a more conservative approach toward the PDA on respiratory, cardiovascular and neurologic outcomes.
Patent Ductus Arteriosus and the Lung: Acute Effects and Long-Term Consequences. Acute Effects and Long-Term Consequences.
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Patent Ductus Arteriosus and the Lung. Acute Effects and Long-Term Consequences.
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Gross-total hematoma removal of hypertensive basal ganglia hemorrhages: A long-term follow-up
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Hypertensive basal ganglia hemorrhage (HBGH) accounts for 35%–44% of cases of hypertensive intracranial hemorrhage (ICH), which is one of the most devastating forms of cerebrovascular disease. In this study, intracerebral hematoma was evacuated with a burr hole craniectomy. The relationships of residue hematoma volume to brain edema, inflammation factors and the long-term prognosis of HBGH patients were studied.
One hundred and seventy-six patients with HBGH were randomly divided into gross-total removal of hematoma (GTRH) and sub-total removal of hematoma (STRH) groups. The pre-operative and post-operative data of the patients in the two groups were compared. The pre-operative data included age, sex, hematoma volume, time from the ictus to the operation, Glasgow Coma Scale (GCS) scores, and the European Stroke Scale (ESS) scores. The post-operative information included edema grade, level of thromboxane B2 (TXB2), 6-keto-prostaglandin F1ɑ (6-K-PGF1ɑ), tumor necrosis factor-ɑ (TNF-ɑ) and endothelin (ET) in hematoma drainage or cerebral spinal fluid (CSF), ESS and Barthel Index (BI).
There was no statistical difference between the two groups (P > 0.05) in the pre-operative data. The levels of TXB2, 6-K-PGF1ɑ, TNF-ɑ and ET in the GTRH group were significantly lower than those in the STRH group at different post-operative times. The ESS in the GTRH group increased rapidly after the operation and was higher than that in the STRH group. There was a significant difference between the two groups (P < 0.05). The post-operative CT scan at different times showed that the brain edema grades were better in the GTRH group than in the STRH group. The BI was higher in the GTRH group than in the STRH group (P < 0.05).
GTRH is an effective method to decrease ICH-induced injury to brain tissue. Such effect is related to decreased perihematomal edema formation and secondary injury by coagulation end products activated inflammatory cascade.
Ontogeny of cerebral and ocular prostanoids and prostanoid receptors: Biological and clinical significance in the perinatal period
1998, Seminars in Neonatology
There exists abundant evidence that prostanoids are important messengers involved in a vast array of biological processes. Recent data suggest those prostanoids exert different roles in the regulation of cerebral and ocular circulation of the newborn compared to the adult. Not only are there ontogenic differences in the cerebral and ocular concentrations of prostanoids, which are higher in the newborn than in the adult, but also their receptor-mediated actions differ with age. Understanding of developmental changes in the characterization and regulation of prostanoid receptors on the cerebral and ocular vasculature sheds significant light on mechanisms that control brain and retinal circulation. In this paper, the results of investigation on ontogeny and developmental regulation of prostanoid receptors and their impact on nitric oxide synthase activity on cerebral and ocular vasculature are reviewed.

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Plasma 6-keto prostaglandin F1α and thromboxane B2 in sick preterm neonates

Abstract

Lancet

Prostagland Med

Lancet

J Pediatr

Prostaglandins

Prostaglandins

Synthesis and metabolism of prostaglandins prostacyclin, and thromboxanes: the arachidonic acid cascade

Sem Perinatol

The role of prostaglandins in the central nervous system

Ann Rev Physiol

Release of prostaglandins and thromboxane into the coronary circulation in patients with ischemic heart disease

N Engl J Med

A comparison of plasma prostaglandin levels in term and preterm labor

Br J Obstet Gynaecol

Perinatal pulmonary prostaglandin production

Am J Physiol

Effects of prostacyclin on the fetal pulmonary circulation

Pediatr Pharmacol

Role of prostaglandins, prostacyclin, and thromboxanes in the control of prenatal patency and postnatal closure of the ductus arteriosus

Sem. Perinatol.

Effect of indomethacin on pulmonary vascular response to ventilation of fetal goats

Am J Physiol

Inhibition of fetal lung maturation by indomethacin in pregnant rabbits

J Perinatol Med

Inhibitors of prostaglandin synthesis, tracheal fluid, and surfactant in fetal lambs

J Appl Physiol

Plasma 6-keto prostaglandin F_1α and thromboxane B₂ in sick preterm neonates