The Journal of Thoracic and Cardiovascular Surgery, Vol 104, 124-129, Copyright © 1992 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Plasma thromboxane and pulmonary artery pressure in neonates treated with extracorporeal membrane oxygenation
KC Bui, G Martin, LA Kammerman, C Hammerman, V Hill and BL Short
Division of Neonatology, Children's Hospital National Medical Center, Washington, DC 20010.
To examine whether neonates with persistent pulmonary hypertension are
subject to a thromboxane-mediated exacerbation of their pulmonary
hypertension during extracorporeal membrane oxygenator therapy (a form of
partial cardiopulmonary bypass), we performed serial measurements of plasma
thromboxane B2 and pulmonary artery pressure before, during, and after
extracorporeal membrane oxygenation. Pulmonary artery pressure was high
before extracorporeal membrane oxygenation, did not increase after the
start of this therapy, but began to decrease after 48 hours of
extracorporeal membrane oxygenation. During the course of extracorporeal
membrane oxygenation, mean pulmonary artery pressure decreased by 50% and
mean plasma thromboxane B2 levels decreased by 70%. In addition, serial
plasma thromboxane B2 levels were significantly correlated with pulmonary
artery pressures in individual infants with a primary diagnosis of meconium
aspiration (r = 0.965 to 0.723). We speculate that the decrease in
pulmonary artery pressure and plasma thromboxane B2 levels over time may
reflect resolution of acute lung injury and that thromboxane B2 may play a
role in regulating pulmonary artery pressure in infants with meconium
aspiration.
