STUDIES ON THE CIRCULATION IN THE NEONATAL PERIOD

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Abstract
Hemodynamic measurements by means of cardiac catheterization were obtained in 38 infants in the first 30 hours after birth. Nineteen of these infants were considered to have normal circulatory and respiratory systems. Nine had mild respiratory distress, and 10 had severe respiratory distress. The circulatory systems of infants with mild respiratory distress did not appreciably differ from the normal. Some infants in both these groups showed evidences of patency of the ductus arteriosus with a small left-to-right shunt for the first 10 to 15 hours after birth. The infants with severe respiratory distress had widely patent ducti, with large left-to-right shunts and, in some instances, right-to-left shunts. The pulmonary arterial and systemic arterial pressures were lower in these infants as compared to the normal and those with mild respiratory symptoms. These characteristics of the severely distressed infants could be related to the disease process, but may be due to prematurity alone. The possible role of left ventricular failure associated with a large left-to-right ductal shunt is discussed. A generalized lack of vasoconstrictor tone could possibly be responsible for systemic and pulmonary arterial hypotension as well as for the widely patent ductus arteriosus.

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