Document Detail

Ligation of medically refracted patent ductus arteriosus (PDA) in an extremely low body weight premature infant.
MedLine Citation:
PMID:  9872552     Owner:  NLM     Status:  MEDLINE    
Medically refracted patent ductus arteriosus (PDA) in an extremely low birth weight (ELBW) preterm (gestation 24 weeks 2 days) infant was successfully ligated under general anesthesia in the neonatal intensive care unit (NICU). Pharmacological agents are more effective to close PDA in preterm infants than in full-term infants, although within 48 h three doses of indomethacin were not sufficient to close PDA in this case. At the age of 69 h the infant developed severe symptoms including bradycardia, systemic hypotension, pulmonary hypertension, diastolic steal (reverse distal aorta flow velocity), and anuria. A PDA ligation was thus performed surgically at 72 h of age. General anesthesia and surgical stress were tolerated by this 531 g infant. Postoperatively all symptoms improved dramatically and the general conditions were stable. On the 38th day the endotracheal tube was extubated and on the 50th day nasogastric milk feeding was started. The oxygen supply was weaned on the 78th day. Growth and development until 6 months were within the normal range of very low birth weight infants. A surgical ligation as early as possible in medically refracted PDA in an ELBW infant is thus considered to be a safe and effective treatment. It prevents the development of further complications of cardiopulmonary vascular problems. Color Doppler echocardiography can reliably measure the PDA size, flow velocity, and hemodynamic changes of persistent PDA, even in tiny infants.
R Pokharel; K Hisano; M Yasufuku; K Ataka; M Okada; S Yoshimoto; H Nakamura
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Surgery today     Volume:  28     ISSN:  0941-1291     ISO Abbreviation:  Surg. Today     Publication Date:  1998  
Date Detail:
Created Date:  1999-03-22     Completed Date:  1999-03-22     Revised Date:  2006-08-03    
Medline Journal Info:
Nlm Unique ID:  9204360     Medline TA:  Surg Today     Country:  JAPAN    
Other Details:
Languages:  eng     Pagination:  1290-4     Citation Subset:  IM    
Department of Surgery, Kobe University School of Medicine, Japan.
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MeSH Terms
Ductus Arteriosus, Patent / complications,  diagnosis,  surgery*
Infant, Newborn
Infant, Premature
Infant, Very Low Birth Weight

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