Cerebral and Splanchnic Hemodynamics after Duct Ligation in Very Low Birth Weight Infants

Objective To describe mesenteric and cerebral blood flow velocities after surgical patent ductus arteriostis (PDA) closure in premature infants. Study design We measured middle cerebral artery (MCA), celiac artery (CA), and superior mesentetic artery (SMA) Doppler ultrasound scanning blood flow velocity (BFV) preoperatively, 3 and 24 hours after ligation. Results We studied 32 infants, with a mean (+/- SD) birthweight of 762 +/- 170 g and gestational age of 25.6 +/- 1.4 weeks at a mean age of 34 13 days. Significant changes in end-diastolic (EDV), average velocity (AV), and vascular resistance were measured in all 3 vessels by 3 hours. AV increased significantly in the CA and SMA within 3 hours; however. no significant increase in MCA AV was found until 24 hours after surgery. Conclusion PDA ligation significantly changes BFV in the MCA, CA. and SMA. In the MCA vascular tone is acutely modulated. with no change in AV at 3 hours. In the CA and SMA, AV increases acutely after ligation. These different patterns of change in BFV suggest region-specific adaptation to surgical PDA closure. (J Pediatr 2009;354:196-200)