Journal article
Enhanced intensive care for the neonatal ductus arteriosus
Acta pædiatrica (Oslo), Vol.95(4), pp.394-403
2006
DOI: 10.1080/08035250500482271
PMID: 16720484
Abstract
Failure of ductal closure is common in extremely low birth weight infants with significant postnatal morbidities from both pulmonary overcirculation (i.e. chronic lung disease) and/or systemic hypoperfusion (i.e. necrotizing enterocolitis). Early clinical signs of a hemodymanically significant ductus may be non-specific (i.e. hypotension, increasing ventilator requirements, metabolic acidosis) necessitating early screening by echocardiography. Cyclooxygenase inhibitors remain the first-line treatment option. Indomethacin remains the most commonly used agent, despite comparable efficacy and reduced risk of adverse events with ibuprofen. Surgical intervention is recommended after failure of medical therapy, contraindications to medical treatment or fulminating duct-related cardiorespiratory deterioration. Wherever possible, surgical intervention in ELBW infants should be avoided in the first week of life due to the potential risks of ischemia-reperfusion cerebral hemorrhage. The postoperative course is often complicated by left ventricular failure, pulmonary edema, and/or hemodynamic instability requiring close monitoring and physiologically relevant therapeutic interventions.
Details
- Title: Subtitle
- Enhanced intensive care for the neonatal ductus arteriosus
- Creators
- Lilian S TEIXEIRA - Division of Neonatology, Department of Paediatrics, The Hospital for Sick Children, Toronto, CanadaPatrick J MCNAMARA - Division of Neonatology, Department of Paediatrics, The Hospital for Sick Children, Toronto, Canada
- Resource Type
- Journal article
- Publication Details
- Acta pædiatrica (Oslo), Vol.95(4), pp.394-403
- Publisher
- Blackwell
- DOI
- 10.1080/08035250500482271
- PMID
- 16720484
- ISSN
- 0803-5253
- eISSN
- 1651-2227
- Language
- English
- Date published
- 2006
- Academic Unit
- Stead Family Department of Pediatrics; Neonatology; Internal Medicine
- Record Identifier
- 9984093469602771
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