[Ductus arteriosus in neonatal cyanotic cardiopathies. Value of the recording of the cutaneous partial pressure of oxygen]

Adaptation to extrauterine life is always precarious in the newborn with cyanotic cardiac malformations. Limited survival is possible in cases with obstructive lesions of the right heart providing ductal closure is delayed. This was monitored in 3 cyanotic neonates with ductal dependant cardiac malformations (tricuspid atresia, transposition of the great arteries with atresia or severe stenosis of the pulmonary valve) by continuous measurement of the cutaneous pO2. The value of cutaneous pO2 monitoring has already been established. It is a reliable indicator of arterial pO2 in the neonatal period. Its major advantage, apart from the possibility of continuous monitoring, is that it is non-invasive and may be performed at the bedside. Analysis of curves recorded over several hours or days showed the cyclical nature of cutaneous pO2, probably related to slow variations in ductal diameter equilibrating effective pulmonary flow, arterial pO2 and ductal constriction. Prolonged hyperoxygenation of these desaturated children does not usually improve their condition; progressive deterioration due to the constrictive effect of oxygen on the ductus may be observed. When a clear decrease in the amplitude of oscillation is recorded ductal closure is imminent and palliative surgery should be undertaken whenever possible.

PMID: 6794478 [PubMed - indexed for MEDLINE]