The Physiologic Closure of the Ductus Arteriosus
نویسندگان
چکیده
The exact time of functional closure of the ductus arteriosus in the newborn human infant has remained a matter of speculation for many years. Studies of human anatomical specimens have shown that complete morphologic closure requires from four to eight weeks (1-5). Animal experiments have been the main approach to the study of functional closure. All workers agree that at the time of birth, but before the onset of respiration and inflation of the lungs, the pressure in the pulmonary artery is equal to or greater than the pressure in the aorta and that a considerable portion of the output of the right ventricle passes through the ductus into the descending aorta. Most workers agree that in animals, with the onset of respiration, there occurs, within a few minutes, a rapid fall in pulmonary artery pressure so that blood no longer flows through the ductus into the aorta. However, Everett and Johnson (6) by injecting radioactive material into the right ventricle and studying the amount appearing in the dorsal aorta distal to the ductus in newborn puppies felt that the flow through the ductus into the aorta may persist for as long as nine hours after birth. There is less agreement about the mechanism of this early functional closure of the ductus. Kennedy and Clark (7-9) observed prompt closure of the guinea pig ductus by muscular contraction during oxygen breathing, but Barron (10) could not corroborate this effect of oxygen in the lamb fetus. Other workers who have studied the closure of the ductus in the newborn lamb by
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تاریخ انتشار 2013