The Journal of Thoracic and Cardiovascular Surgery, Vol 101, 612-617, Copyright © 1991 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Plasma prostanoids in neonatal extracorporeal membrane oxygenation. Influence of meconium aspiration
KC Bui, C Hammerman, R Hirschl, SM Snedecor, KJ Cheng, L Chan, BL Short and RH Bartlett
Division of Neonatology/ECMO, Children's Hospital National Medical Center, Washington, D.C.
Thromboxane B2 may be a mediator of neonatal persistent pulmonary
hypertension. Elevated levels of plasma thromboxane and prostacyclin have
been described previously in hypoxic newborn infants with neonatal
pulmonary hypertension. We measured serial plasma levels of thromboxane B2
and 6-keto-prostaglandin F1 alpha (stable metabolite of prostacyclin) in 21
newborn infants with severe respiratory failure and pulmonary hypertension
who required extracorporeal membrane oxygenation support. We sought to
study (1) the evolution of plasma prostanoids in pulmonary hypertensive
infants treated with extracorporeal membrane oxygenation and (2) whether
different pulmonary hypertensive diagnostic subgroups have distinctive
prostanoid profiles. Our data indicated that infants with meconium
aspiration had significantly lower levels of plasma thromboxane B2 and
6-keto-prostaglandin F1 alpha while receiving extracorporeal membrane
oxygenation than did infants with persistent pulmonary hypertension but no
meconium aspiration. Levels of all infants decreased progressively as
extracorporeal membrane oxygenation support continued.