ArticleThe Journal of pediatrics2014
Hypotension following patent ductus arteriosus ligation: the role of adrenal hormones.
Article in The Journal of pediatrics, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 56 citations in OpenAlex.
- Catecholamine-resistant hypotension and myocardial performance following patent ductus arteriosus ligation.Journal of perinatology : official journal of the California Perinatal Association · 2015Trial
- Changes in cardiorespiratory status after transcatheter patent ductus arteriosus closure.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- Prophylactic indomethacin and the risk of serious pulmonary hemorrhages in preterm infants less than 28 weeks' gestation.Journal of perinatology : official journal of the California Perinatal Association · 2024Article
- Prophylactic indomethacin, antenatal betamethasone, and the risk of intestinal perforation in infants <28 weeks' gestation.Journal of perinatology : official journal of the California Perinatal Association · 2023Observational
- Effects of Milrinone on Neonates after Patent Ductus Arteriosus Ligation: A Retrospective Nationwide Database Study.Neonatology · 2023Article
- Phenotyping respiratory decompensation following definitive closure of the patent ductus arteriosus in preterm infants.Journal of perinatology : official journal of the California Perinatal Association · 2022Article
- The effect of prolonged tracheal intubation on the association between patent ductus arteriosus and bronchopulmonary dysplasia (grades 2 and 3).Journal of perinatology : official journal of the California Perinatal Association · 2020Observational
- Precision medicine in neonatal hemodynamics: need for prioritization of mechanism of illness and defining population of interest.Journal of perinatology : official journal of the California Perinatal Association · 2020Article
- Comparison of 'post-patent ductus arteriosus ligation syndrome' in premature infants after surgical ligation vs. percutaneous closure.Journal of perinatology : official journal of the California Perinatal Association · 2020Article
- Patent ductus arteriosus in preterm infants: is early transcatheter closure a paradigm shift?Journal of perinatology : official journal of the California Perinatal Association · 2019Review
- Article
- Adrenal insufficiency in neonates undergoing cardiopulmonary bypass and postoperative hypothalamic-pituitary-adrenal function after prophylactic glucocorticoids.Journal of perinatology : official journal of the California Perinatal Association · 2019Observational
- A comparison of postoperative outcomes with PDA ligation in the OR versus the NICU: a retrospective cohort study on the risks of transport.BMC anesthesiology · 2018Article
- Changing patterns of patent ductus arteriosus surgical ligation in the United States.Seminars in perinatology · 2018Review
- Circulatory Insufficiency and Hypotension Related to the Ductus Arteriosus in Neonates.Frontiers in pediatrics · 2018Review
- Treatment and Nontreatment of the Patent Ductus Arteriosus: Identifying Their Roles in Neonatal Morbidity.The Journal of pediatrics · 2017Article
- Prophylactic Indomethacin Compared with Delayed Conservative Management of the Patent Ductus Arteriosus in Extremely Preterm Infants: Effects on Neonatal Outcomes.The Journal of pediatrics · 2017Article
- Effects of Prophylactic Indomethacin on Vasopressor-Dependent Hypotension in Extremely Preterm Infants.The Journal of pediatrics · 2017Article
- Antenatal Betamethasone: A Prolonged Time Interval from Administration to Delivery Is Associated with an Increased Incidence of Severe Intraventricular Hemorrhage in Infants Born before 28 Weeks Gestation.The Journal of pediatrics · 2016Article
- The impact of a dedicated patent ductus arteriosus ligation team on neonatal health-care outcomes.Journal of perinatology : official journal of the California Perinatal Association · 2016Article
Corrections and comments
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Authors and funding
22 authors at 13 institutions in 2 countries.
Funding
Abstract
objectiveTo test the hypothesis that an impaired adrenal response to stress might play a role in the hypotension that follows patent ductus arteriosus (PDA) ligation. STUDY
designWe performed a multicenter study of infants born at <32 weeks' gestation who were about to undergo PDA ligation. Serum adrenal steroids were measured 3 times: before and after a cosyntropin (1.0 μg/kg) stimulation test (performed before the ligation), and at 10-12 hours after the ligation. A standardized approach for diagnosis and treatment of postoperative hypotension was followed at each site. A modified inotrope score (1 × dopamine [μg/kg/min] + 1 × dobutamine) was used to monitor the catecholamine support an infant received. Infants were considered to have catecholamine-resistant hypotension if their greatest inotrope score was >15.
resultsOf 95 infants enrolled, 43 (45%) developed hypotension and 14 (15%) developed catecholamine-resistant hypotension. Low postoperative cortisol levels were not associated with the overall incidence of hypotension after ligation. However, low cortisol levels were associated with the refractoriness of the hypotension to catecholamine treatment. In a multivariate analysis: the OR for developing catecholamine-resistant hypotension was OR 36.6, 95% CI 2.8-476, P = .006. Low cortisol levels (in infants with catecholamine-resistant hypotension) were not attributable to adrenal immaturity or impairment; their cortisol precursor concentrations were either low or unchanged, and their response to cosyntropin was similar to infants without catecholamine-resistant hypotension.
conclusionInfants with low cortisol concentrations after PDA ligation are likely to develop postoperative catecholamine-resistant hypotension. We speculate that decreased adrenal stimulation, rather than an impaired adrenal response to stimulation, may account for the decreased production.
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