Patent ductus arteriosus is common among premature neonates, especially those with birth weights less than 1,500 g. In vitro, room light inhibits the contraction of immature piglet's ductal rings. Because phototherapy is used frequently from the first days of life to treat jaundice in preterm neonates, we compared the occurrence of patent ductus arteriosus among premature infants exposed to this intense light source with those whose chests were shielded. Seventy-four babies with respiratory distress syndrome were randomly assigned to either a treatment group (chest shielded with aluminum foil while on phototherapy, 36 babies) or control group (no shield, 38 babies). All were on radiant warmers, received mechanical ventilation for respiratory distress syndrome, and phototherapy (Air Shields model PTU 78-1) from day 1 of life. Irradiance was maintained at 4.0 μW/cm2m in all cases. Although both groups had similar birth weights, gestational ages, severity of respiratory distress syndrome, intravenous fluid intake, and duration of phototherapy, the incidence of patent ductus arteriosus was significantly less in the shield group (shield 11/36 v No shield 23/38; P = .009). Patent ductus arteriosus murmurs developed in shielded patients at a later date, they required less vigorous treatment (ie, indomethacin), and they had shorter hospitalizations (74 v 85 days; P .05). The significant reduction of patent ductus arteriosus with shielding suggests that phototherapy may play a role in the occurrence of patent ductus arteriosus in premature infants. Shielding may be a practical method to decrease this common complication should this initial observation be confirmed.
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机译：动脉导管未闭在早产婴儿中很常见，尤其是那些出生体重小于1,500 g的婴儿。在体外，室内光线会抑制未成熟仔猪的导管环的收缩。由于光疗从出生的第一天开始就经常用于治疗早产儿黄疸，因此我们比较了暴露于这种强光源下的早产婴儿和胸部被遮盖的婴儿中动脉导管未闭的发生率。将74名患有呼吸窘迫综合征的婴儿随机分为治疗组（光疗时用铝箔屏蔽的胸部，36例婴儿）或对照组（无防护罩，38例）。从生命的第一天起，所有患者均接受辐射加热器，接受机械通气以治疗呼吸窘迫综合征，并接受光疗（Air Shields PTU 78-1型）。在所有情况下，辐照度均保持> 4.0μW/ cm2 / nm。尽管两组的出生体重，胎龄，呼吸窘迫综合征的严重程度，静脉输液量和光疗时间相似，但屏蔽组动脉导管未闭的发生率显着降低（屏蔽11/36 v无屏蔽23/38 ; P = .009）。受保护的患者后来出现动脉导管未闭杂音，需要较少的积极治疗（即消炎痛），住院时间较短（74 v 85天; P <.05）。屏蔽显着减少动脉导管未闭提示光疗可能在早产儿动脉导管未闭的发生中起作用。如果初步确认，屏蔽可能是减少这种常见并发症的实用方法。
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