Significant correlations between the flow volume of patent ductus venosus and early neonatal liver function: possible involvement of patent ductus venosus in post- natal liver function

Kei Murayama ^1*, Hironori Nagasaka ¹, Kenji Tate ², Yoshiteru Ohsone ², Masaki Kanazawa ³, Kunihiko Kobayashi ⁴, Yoichi Kohno ³ and Masaki Takayanagi ¹

¹ Chiba Children's Hospital, Japan
² Department of Neonatology, Kimitsu Chuo Hospital, Japan
³ Department of Pediatrics, Chiba University Graduate School of Medicine, Japan
⁴ Department of Pediatrics, Hokkaido University Graduate School of Medicine, Japan

^* To whom correspondence should be addressed. E-mail: kmuraya{at}mri.biglobe.ne.jp.

Accepted 25 November 2005

Abstract

Objective: The biochemical features of porto- systemic venous shunt with high flow volume are hypergalactosemia, hyperammonemia, prolonged blood coagulation time, and an elevation of the serum bile acid level. The ductus venosus remains open with shunt flow in most neonates for a certain period after birth. However, the effects of blood flow through the ductus venosus on neonatal liver function remain unclear. The aim of the present study was to elucidate the impact of patency of the ductus venosus on liver function in early neonates.

Methods: Subjects were divided into three groups by gestational age (group I, 29-32 weeks; group II, 33- 36 weeks; group III, 37-41 weeks). The shunt flow volume through the ductus venosus was examined serially using ultrasonography, and the correlations between flow volume and liver function in the respective groups were estimated during the first week after birth.

Results: Group I had a higher flow volume and later timing of functional closure compared with the other two groups. Plasma ammonia and serum total bile acid levels were correlated with flow volume in groups I and II, while blood galactose and galactose-1-phosphate levels were significantly correlated with flow volume in group III. Percent hepaplastin was also significantly correlated with flow volume in all groups, but the plasma vitamin K level was not significantly correlated with flow volume in any group.

Conclusions: Patent ductus venosus has a considerable impact on crucial liver functions such as ammonia detoxification, blood coagulation and regulation of serum total bile acid level in early neonates.

Keywords: gestational age, liver function, neonate, patent ductus venosus, porto-systemic venous shunt

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?