02 pM of free NO that can reach the vascular wall, because of a strong self-capture effect. However, it is worth noting that this value is in the same range as erythrocytic hemoglobin-generated NO that is able to diffuse freely out of the cell, despite the tremendous difference in hemoglobin concentration in both cases (pM hemoglobin in plasma vs. mM in erythrocyte); (3) intraerythrocytic hemoglobin encapsulated by a NO-resistant membrane is the major source of NO from nitrite reduction, and cell-free hemoglobin is a significant scavenger of both paracrine and endocrine NO. (c)

2007 Elsevier Inc. All rights reserved.”
“Objective: We sought to analyze p53 inhibitor the effect of patent ductus arteriosus diameter on treatment success in premature neonates.

Methods: Among 537 consecutive neonates born between 1985 and 2005 with a diagnosed patent ductus arteriosus, 201 premature patients (< 35 weeks’ gestation) treated for a hemodynamically significant patent ductus arteriosus were retrospectively reviewed. Two groups were compared: group MED (n = 154; successful treatment with indomethacin) and group

FAIL (n = 47; failure see more of medication to reduce the patent ductus arteriosus diameter to hemodynamic insignificance).

Results: After unsuccessful medical LY3039478 treatment, 33 patients required surgical patent ductus arteriosus closure, 12 died before further possible treatment, and 2 were discharged home without clinical symptoms but with an open patent ductus arteriosus. Mean patent ductus arteriosus diameter in the FAIL group (2.8 +/- 0.9 mm) was significantly larger than that in the MED group (2.4 +/- 0.6 mm, P < .01). Assisted respiration time (ventilation plus continuous positive airway pressure) before patent ductus arteriosus closure was longer in the FAIL group (20 days) than in the MED group

(9 days, P < .001) but was similar after patent ductus arteriosus closure. By using an index of patent ductus arteriosus diameter squared/birth weight (in square millimeters per kilogram), a cutoff value of less than 9 mm(2)/kg correctly predicts medical patent ductus arteriosus closure in 87.5% of patients. Values of greater than 9 mm(2)/kg correctly predict medication failure in 41.5% of patients.

Conclusions: In preterm babies requiring surgical patent ductus arteriosus closure, longer respiration times reflect a delay while attempting medical treatment, but respiration time is equally short between groups after shunt elimination. Medical treatment, although a valid first option, is likely to fail with larger patent ductus arteriosus diameters and lower birth weights.