Postnatal 38.Günde Oral Parasetamol Tedavisiyle Kapanan Hemodinamik Anlamlı Patent Duktus Arteriosus Olgusu

Abstract

Patent duktus arteriosus özellikle küçük prematürelerin önemli sorunlarından biridir. 25 gebelik haftasında 515 gr ağırlığında doğan prematüre bebek yenidoğan servisine yatırıldı.Respiratuvar distres sendromu (RDS) nedeniyle  iki kez surfaktan tedavisi uygulanan hastanın postnatal 25.günde hemodinamik anlamlı patent duktus arteriosus (PDA) saptanması nedeniyle hastaya 2 kür oral ibuprofen tedavisi verildi.İbuprofen sonrası duktusu kapanan hastanın postnatal 38.günde klinik ve laboratuvar olarak sepsis gelişen hastanın ekokardiyografisinde(EKO) duktusunun  açıldığı ve hemodinamik anlamlı olduğu saptandı. Trombositopenisi olması nedeniyle hastaya medikal kapatma tedavisi olarak oral parasetamol  başlandı.Oral parasetamol tedavisi sonrası kontrol EKO’sunda PDA’nın kapandığı görüldü.Klinik izleminde hastanın genel durumu  iyi seyretti.Postnatal 110.günde 2120 grama ulaşan hasta yenidoğan polikliniğine kontrole gelmek üzere taburcu edildi.Sonuç olarak ibuprofen tedavisine yanıt vermeyen ya da ibuprofen tedavisinin kontrendike olduğu durumlarda geç dönemde de parasetamol tedavisi alternatif seçenek olabilir.

Keywords

• prematüre,oral parasetamol

A Hemodynamically Significant Patent Ductus Arteriosus Case which was Closed at 38th Day with Oral Paracetamol Therapy

Abstract

Patent ductus arteriosus is one of the important problem in premature infants. A premature infant weighed 515 g at 25th week of gestation was admitted in the neonatal intensive care unit. The patient administered surfactant therapy two times for respiratory distress syndrome (RDS) was given 2 cure of oral ibuprofen therapy due to hemodynamically significant patent ductus arteriosus (PDA) detected. Echocardiography of the patient whom ductus was closed after ibuprofen therapy and who clinically and laboratorially developed sepsis at the 38th postnatal day revealed that the ductus was hemodynamically significantly open. Upon the patient had thrombocytopenia, oral paracetamol therapy was initiated as medical closure treatment. After the treatment, control ECHO showed a closed PDA. General status of the patient was normal during the follow-up. The patient reached to 2,120 g at the 110th postnatal day, and was discharged to home with outpatient clinic control plan. In conclusion, paracetamol treatment may be an alternative option also in late periods in the cases of unresponsiveness to ibuprofen or a contraindication for this agent.      

Keywords

• premature,oral paracetamol

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