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

Year 2019, Volume: 50 Issue: 3, 156 - 158, 15.09.2019

Selahattin Akar Veysi Almaz Mehmet Turgut

https://doi.org/10.16948/zktipb.447404

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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