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Management Of Patent Ductus Arteriosus

Yıl 2017, Cilt: 9 Sayı: 4, 33 - 37, 20.07.2017

Öz

Abstract

Although it is known that patent ductus arteriosus (PDA) is associated with neonatal morbidities such as intraventricular hemorrhage, bronchopulmonary dysplasia,and necrotizing enterocolitis, most therapeutic approaches have failed to show improvement in these outcomes. During the last years therapy for PDA has gone thro-ugh a full circle from conservative therapy to aggressive medical and surgical therapy and back to conservative management. There is no consensus regarding whomto treat, when to treat, and how to treat. Further studies are needed for both diagnosis and treatment that take into account modern practices, including antenatal corticosteroid use, minimally invasive respiratory support, and minimal oxygen on day 2 or 3 after birth. For diagnosis, comprehensive risk assessment tools are needed that include patient characteristics, ductrelated variables, parameters incorporating effects of the duct on other organ systems, and echocardiographic markers at the time of decision making. From a treatment perspective, multicenter randomized studiesare required to evaluate the long-term cardiovascular, respiratory, and neurodevelopmental outcomes of conservative, prophylactic, early asymptomatic and symptomatic treatment, and different theurapatic agents.

Kaynakça

  • Kaynaklar 1.Arcilla RA, Thilenius OG, Ranniger K. Congestive heart fai-lure from suspected ductal closure in utero. J Pediatr1969;75:74-8. 2.Chiruvolu A, Jaleel M. Therapeutic management of patent duc-tus arteriosus. Early Human Dev 2009;85(3):151-5. 3.Clyman RI. Mechanisms regulating the ductus arteriosus. BiolNeonate 2006;89:330-5. 4.Chiruvolu A, Punjwani P, Ramaciotti C. Clinical and echo-cardiographic diagnosis of patent ductus arteriosus in prema-ture neonates. Early Hum Dev 2009;85(3):147-9. 5.Overmeire B, Chemtob S. The pharmacologic closure of thepatent ductus arteriosus. Semin Fetal Neonatal Med2005;10(2):177-84. 6.Brown RE. Increased risk of bronchopulmonary dysplasia in in-fants with patent ductus arteriosus. J Pediatr 1979;95:865-6. 7.Evans N, Kluckow M. Early ductal shunting and intraventri-cular hemorrhage in ventilated preterm infants. Arch Dis ChildFetal Neonatal Ed. 1996;75:F183-6. 8.El-Khuffash A, Barry D, Walsh K, Davis PG, Molloy EJ. Bi-ochemical markers may identify preterm infants with a patentductus arteriosus at high risk of death or severe intraventri-cular haemorrhage. Arch Dis Child Fetal Neonatal Ed2008;93(6):F407-12. 9.McNamara PJ, Sehgal A. Towards rational management ofthe patent ductus arteriosus: the need for disease staging. ArchDis Child Fetal Neonatal Ed 2007;92:F424-7. 10.Nemerofsky SL, Parravicini E, Batemean D, Kleinman C, PolinRA, Lorenz JM. The ductus arteriosus rarely requires treatmentin infants >1000 grams. Am J Perinatol 2008;25:661-6. 11.Koch J, Hensley G, Roy L, Brown S, Ramaciotti C, RosenfeldCR. Prevalence of spontaneous closure of the ductus arterio-sus in neonates at a birth weight of 1000 grams or less. Pe-diatrics 2006;117:1113-21. 12.Philips JB, Garcia-Pratz JA, Fulton DR, Kim MS. Manage-ment of patent ductus arteriosus in preterm infants.http://www.uptodate.com/contents 13.Bhat R, Das UG. Management of patent ductus arteriosus inpremature infants. Indian J Pediatr 2015;82(1):53-60. 14.Prematüre Bebekte Patent Duktus Arteriosus’a Yaklaşım Reh-beri 2016. Türk Neonatoloji Derneği Rehberleri (www.neo-natology.org.tr). 15.Souvik M, Ronnestad A, Holstrom H. Management of patentductus arteriosus in preterm infants- Where do we stand? Con-genit Heart Dis 2013;8:500-11. 16.Writing group of the American Society of Echocardiography(ASE) in collaboration with the European Association of Ec-hocardiography (EAE) and the Association for European Pe-diatric Cardiologists (AEPC). Targeted neonatal echocardi-ography in the neonatal intensive care unit: practice guide-lines and recommendations for training. Eur J Echocardiog-raphy 2011;12:715-36. 17.Evans N, Malcolm G, Osborn D, Kluckow M. Diagnosis of patentductus arteriosus in preterm infants. Neo Rev 2004;5:e86-97. 18.Jain A, Shah PS. Diagnosis, evaluation, and management ofpatent ductus arteriosus in preterm neonates. JAMA Pediatr2015;169(9):863-72 .19.Choi BM, Lee KH, Eun BL, Yoo KH, Hong YS, Son CS, et al.Utility of rapid B –natriuretic peptide assay for diagnosis ofsymptomatic patent ductus arteriosus in preterm infants. Pe-diatrics 2005;115:e255-61. 20.Zonnenberg I, deWaal K. The definition of a haemodynamicsignificant duct in randomized controlled trials: a systema-tic literature review. Acta Paediatr 2012;101(3):247-51. 21.Marshall DD, Kotelchuck M, Young TE, Bose CL, Kruyer L,O'Shea TM. Risk factors for chronic lung disease in the sur-factant era: a North Carolina population-based study of verylow birth weight infants. North Carolina Neonatologists As-sociation. Pediatrics 1999;104:1345-50. 22.Rozé JC, Cambonie G, Marchand-Martin L, Gournay V, Durr-meyer X, Durox M, et al. Hemodynamic EPIPAGE 2 StudyGroup. Association between early screening for Patent Duc-tus Arteriosus and in-hospital mortality among extremely pre-term infants. JAMA 2015;313:2441-8. 23.Bhandari V, Zhou G, Bizzarro MJ, Buhimschi C, Hussain N,Gruen JR, et al. Genetic contribution to patent ductus arterio-sus in the premature newborn. Pediatrics 2009; 123: 669-73. 24.Sellmer A, Bjerre JV, Schmidt MR, McNamara PJ, Hjort-dal VE, Host B, et al. Morbidity and mortality in preterm neo-nates with patent ductus arteriosus on day 3. Arch Dis ChildFetal Neonatal Ed 2013;98(6):F505-10. 25.Bell EF, Acaregui MJ. Restricted versus liberal water inta-ke for preventing morbidity and mortality in preterm infants.Cochrane Database Syst Rev. 2008;1:CD000503. 26.Bhat R, Fisher E, Raju TNK, Vidyasagar D. Patent ductus ar-teriosus: recent advances in diagnosis and management. Pe-diatr Clin North Am 1982;29:1117-36. 27.Brooks JM, Travadi JN, Patole SK, Doherty DA, Simmer K.Is surgical ligation of patent ductus arteriosus necessary? theWestern Australian experience of conservative management.Arch Dis Child Fetal Neonatal Ed 2005;90(3):F235-39. 28.Vanhaesebrouck S, Zonnenberg I, Vandervoort P, Bruneel E,Van Hoestenberghe MR, Theyskens C. Conservative treatmentfor patent ductus arteriosus in the preterm. Arch Dis Child Fe-tal Neonatal Ed 2007;92(4):F244-F247. 29.Irmesi R, Marcialis MA, Anker JVD, Fanos V. Non-steroidalanti-inflammatory drugs (NSAIDs) in the management of pa-tent ductus arteriosus (PDA) in preterm infants and variati-ons in attitude in clinical practice: a flight around the world.Curr Med Chem 2014;21(27):3132-52. 30.Ohlsson A, Walia R, Shah SS. Ibuprofen for the treatment ofpatent ductus arteriosus in preterm or low birth weight (or both)infants. Cochrane Database Syst Rev. 2015;2(2):CD003481. 31.Oncel MY, Yurttutan S, Erdeve O, Uras N, Altug N, Oguz SS,et al. Oral paracetamol versus oral ibuprofen in the manage-ment of patent ductus arteriosus in preterm infants: a rando-mized controlled trial. J Pediatr 2014;164(3):510-4.e1. 32.Ohlsson A, Shah PS. Paracetamol (acetaminophen) for patentductus arteriosus in preterm or low- birth-weight infants. Coch-rane Database Syst Rev. 2015;3(3):CD010061. 33.Neumann R, Schulzke SM, Bührer C.Oral ibuprofen versus in-travenous ibuprofen or intravenous indomethacin for the treat-ment of patent ductus arteriosus in preterm infants: a systema-tic review and meta-analysis. Neonatology 2012;102(1):9-15. 34.Dang D, Wang D, Zhang C, Zhou W, Zhou Q, Wu H. Com-parison of oral paracetamol versus ibuprofen in premature in-fants with patent ductus arteriosus: a randomized controlledtrial. PLoS One. 2013;8(11):e77888. 35.Prescott S, Keim-Malpass J. Patent ductus arteriosus in thepreterm infant: Diagnostic and treatment options. Adv Neo-natal Care 2017;17(1):10-8. 36.Weiss H, Cooper B, Brook M, Schlueter M, Clyman R. Fac-tors determining reopening of the ductus arteriosus after suc-cessful clinical closure with indomethacin. J Pediatr1995;127:466- 471. 37.Kenny D, Morgan GJ, Bentham JR, Wilson N, Martin R, To-metzki A, et al. Early clinical experience with a modified am-platzer ductal occluder for transcatheter arterial duct occlu-sion in infants and small children. Catheter Cardiovasc In-terv 2013 Jun 29. doi: 10.1002/ccd

Patent Duktus Arteriyozus Yönetimi

Yıl 2017, Cilt: 9 Sayı: 4, 33 - 37, 20.07.2017

Öz

Öz

Patent duktus arteriyozusun (PDA), intraventiküler kanama, bronkopulmoner displazi, nekrotizan enterokolit gibi yenidoğan morbiditeleri ile ilişkisinin bilinmesinerağmen, tedavi yaklaşımlarının bu komplikasyonları önleyemediği gösterilmiştir.PDA’ya yaklaşım, yıllar içinde konservatif tedaviden agresif medikal ve cerrahi tedaviye kaymışken, günümüzde tekrar konservatif tedavi ağırlıklı bir yaklaşım ağırlık kazanmaya başlamıştır. PDA’nın hangi bebekte, ne zaman ve nasıl tedavi edileceği konusunda görüş birliği bulunmamaktadır. PDA tanısı ve tedavisine yönelik, antenatal steroid kullanımı, minimal invaziv solunum desteği, doğumdan sonraki ikiveya üç günde minimal oksijen kullanımı gibi güncel yaklaşımları da içeren daha fazla çalışmaya ihtiyaç duyulmaktadır. Tanı için, hasta özelliklerini, duktus değişkenlerini, duktusun diğer organlara etkisini gösteren parametreleri ve karar anında ekokardiyografi bulgularını içeren, risk değerlendirme ölçekleri geliştirilmelidir. Tedavi için, konservatif, profilaktik, erken semptomatik ve semptomatik tedavinin, fark-lı ajanların uzun dönem kardiyovasküler, solunum ve nörogelişimsel sonuçları ile de-ğerlendirildiği randomize çok merkezli çalışmalara gereksinim bulunmaktadır.

Kaynakça

  • Kaynaklar 1.Arcilla RA, Thilenius OG, Ranniger K. Congestive heart fai-lure from suspected ductal closure in utero. J Pediatr1969;75:74-8. 2.Chiruvolu A, Jaleel M. Therapeutic management of patent duc-tus arteriosus. Early Human Dev 2009;85(3):151-5. 3.Clyman RI. Mechanisms regulating the ductus arteriosus. BiolNeonate 2006;89:330-5. 4.Chiruvolu A, Punjwani P, Ramaciotti C. Clinical and echo-cardiographic diagnosis of patent ductus arteriosus in prema-ture neonates. Early Hum Dev 2009;85(3):147-9. 5.Overmeire B, Chemtob S. The pharmacologic closure of thepatent ductus arteriosus. Semin Fetal Neonatal Med2005;10(2):177-84. 6.Brown RE. Increased risk of bronchopulmonary dysplasia in in-fants with patent ductus arteriosus. J Pediatr 1979;95:865-6. 7.Evans N, Kluckow M. Early ductal shunting and intraventri-cular hemorrhage in ventilated preterm infants. Arch Dis ChildFetal Neonatal Ed. 1996;75:F183-6. 8.El-Khuffash A, Barry D, Walsh K, Davis PG, Molloy EJ. Bi-ochemical markers may identify preterm infants with a patentductus arteriosus at high risk of death or severe intraventri-cular haemorrhage. Arch Dis Child Fetal Neonatal Ed2008;93(6):F407-12. 9.McNamara PJ, Sehgal A. Towards rational management ofthe patent ductus arteriosus: the need for disease staging. ArchDis Child Fetal Neonatal Ed 2007;92:F424-7. 10.Nemerofsky SL, Parravicini E, Batemean D, Kleinman C, PolinRA, Lorenz JM. The ductus arteriosus rarely requires treatmentin infants >1000 grams. Am J Perinatol 2008;25:661-6. 11.Koch J, Hensley G, Roy L, Brown S, Ramaciotti C, RosenfeldCR. Prevalence of spontaneous closure of the ductus arterio-sus in neonates at a birth weight of 1000 grams or less. Pe-diatrics 2006;117:1113-21. 12.Philips JB, Garcia-Pratz JA, Fulton DR, Kim MS. Manage-ment of patent ductus arteriosus in preterm infants.http://www.uptodate.com/contents 13.Bhat R, Das UG. Management of patent ductus arteriosus inpremature infants. Indian J Pediatr 2015;82(1):53-60. 14.Prematüre Bebekte Patent Duktus Arteriosus’a Yaklaşım Reh-beri 2016. Türk Neonatoloji Derneği Rehberleri (www.neo-natology.org.tr). 15.Souvik M, Ronnestad A, Holstrom H. Management of patentductus arteriosus in preterm infants- Where do we stand? Con-genit Heart Dis 2013;8:500-11. 16.Writing group of the American Society of Echocardiography(ASE) in collaboration with the European Association of Ec-hocardiography (EAE) and the Association for European Pe-diatric Cardiologists (AEPC). Targeted neonatal echocardi-ography in the neonatal intensive care unit: practice guide-lines and recommendations for training. Eur J Echocardiog-raphy 2011;12:715-36. 17.Evans N, Malcolm G, Osborn D, Kluckow M. Diagnosis of patentductus arteriosus in preterm infants. Neo Rev 2004;5:e86-97. 18.Jain A, Shah PS. Diagnosis, evaluation, and management ofpatent ductus arteriosus in preterm neonates. JAMA Pediatr2015;169(9):863-72 .19.Choi BM, Lee KH, Eun BL, Yoo KH, Hong YS, Son CS, et al.Utility of rapid B –natriuretic peptide assay for diagnosis ofsymptomatic patent ductus arteriosus in preterm infants. Pe-diatrics 2005;115:e255-61. 20.Zonnenberg I, deWaal K. The definition of a haemodynamicsignificant duct in randomized controlled trials: a systema-tic literature review. Acta Paediatr 2012;101(3):247-51. 21.Marshall DD, Kotelchuck M, Young TE, Bose CL, Kruyer L,O'Shea TM. Risk factors for chronic lung disease in the sur-factant era: a North Carolina population-based study of verylow birth weight infants. North Carolina Neonatologists As-sociation. Pediatrics 1999;104:1345-50. 22.Rozé JC, Cambonie G, Marchand-Martin L, Gournay V, Durr-meyer X, Durox M, et al. Hemodynamic EPIPAGE 2 StudyGroup. Association between early screening for Patent Duc-tus Arteriosus and in-hospital mortality among extremely pre-term infants. JAMA 2015;313:2441-8. 23.Bhandari V, Zhou G, Bizzarro MJ, Buhimschi C, Hussain N,Gruen JR, et al. Genetic contribution to patent ductus arterio-sus in the premature newborn. Pediatrics 2009; 123: 669-73. 24.Sellmer A, Bjerre JV, Schmidt MR, McNamara PJ, Hjort-dal VE, Host B, et al. Morbidity and mortality in preterm neo-nates with patent ductus arteriosus on day 3. Arch Dis ChildFetal Neonatal Ed 2013;98(6):F505-10. 25.Bell EF, Acaregui MJ. Restricted versus liberal water inta-ke for preventing morbidity and mortality in preterm infants.Cochrane Database Syst Rev. 2008;1:CD000503. 26.Bhat R, Fisher E, Raju TNK, Vidyasagar D. Patent ductus ar-teriosus: recent advances in diagnosis and management. Pe-diatr Clin North Am 1982;29:1117-36. 27.Brooks JM, Travadi JN, Patole SK, Doherty DA, Simmer K.Is surgical ligation of patent ductus arteriosus necessary? theWestern Australian experience of conservative management.Arch Dis Child Fetal Neonatal Ed 2005;90(3):F235-39. 28.Vanhaesebrouck S, Zonnenberg I, Vandervoort P, Bruneel E,Van Hoestenberghe MR, Theyskens C. Conservative treatmentfor patent ductus arteriosus in the preterm. Arch Dis Child Fe-tal Neonatal Ed 2007;92(4):F244-F247. 29.Irmesi R, Marcialis MA, Anker JVD, Fanos V. Non-steroidalanti-inflammatory drugs (NSAIDs) in the management of pa-tent ductus arteriosus (PDA) in preterm infants and variati-ons in attitude in clinical practice: a flight around the world.Curr Med Chem 2014;21(27):3132-52. 30.Ohlsson A, Walia R, Shah SS. Ibuprofen for the treatment ofpatent ductus arteriosus in preterm or low birth weight (or both)infants. Cochrane Database Syst Rev. 2015;2(2):CD003481. 31.Oncel MY, Yurttutan S, Erdeve O, Uras N, Altug N, Oguz SS,et al. Oral paracetamol versus oral ibuprofen in the manage-ment of patent ductus arteriosus in preterm infants: a rando-mized controlled trial. J Pediatr 2014;164(3):510-4.e1. 32.Ohlsson A, Shah PS. Paracetamol (acetaminophen) for patentductus arteriosus in preterm or low- birth-weight infants. Coch-rane Database Syst Rev. 2015;3(3):CD010061. 33.Neumann R, Schulzke SM, Bührer C.Oral ibuprofen versus in-travenous ibuprofen or intravenous indomethacin for the treat-ment of patent ductus arteriosus in preterm infants: a systema-tic review and meta-analysis. Neonatology 2012;102(1):9-15. 34.Dang D, Wang D, Zhang C, Zhou W, Zhou Q, Wu H. Com-parison of oral paracetamol versus ibuprofen in premature in-fants with patent ductus arteriosus: a randomized controlledtrial. PLoS One. 2013;8(11):e77888. 35.Prescott S, Keim-Malpass J. Patent ductus arteriosus in thepreterm infant: Diagnostic and treatment options. Adv Neo-natal Care 2017;17(1):10-8. 36.Weiss H, Cooper B, Brook M, Schlueter M, Clyman R. Fac-tors determining reopening of the ductus arteriosus after suc-cessful clinical closure with indomethacin. J Pediatr1995;127:466- 471. 37.Kenny D, Morgan GJ, Bentham JR, Wilson N, Martin R, To-metzki A, et al. Early clinical experience with a modified am-platzer ductal occluder for transcatheter arterial duct occlu-sion in infants and small children. Catheter Cardiovasc In-terv 2013 Jun 29. doi: 10.1002/ccd
Toplam 1 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular İç Hastalıkları
Bölüm makale
Yazarlar

Uzm. Dr. Emel Okulu

Yayımlanma Tarihi 20 Temmuz 2017
Yayımlandığı Sayı Yıl 2017 Cilt: 9 Sayı: 4

Kaynak Göster

APA Okulu, U. D. E. (2017). Patent Duktus Arteriyozus Yönetimi. Klinik Tıp Pediatri Dergisi, 9(4), 33-37.
AMA Okulu UDE. Patent Duktus Arteriyozus Yönetimi. Pediatri. Temmuz 2017;9(4):33-37.
Chicago Okulu, Uzm. Dr. Emel. “Patent Duktus Arteriyozus Yönetimi”. Klinik Tıp Pediatri Dergisi 9, sy. 4 (Temmuz 2017): 33-37.
EndNote Okulu UDE (01 Temmuz 2017) Patent Duktus Arteriyozus Yönetimi. Klinik Tıp Pediatri Dergisi 9 4 33–37.
IEEE U. D. E. Okulu, “Patent Duktus Arteriyozus Yönetimi”, Pediatri, c. 9, sy. 4, ss. 33–37, 2017.
ISNAD Okulu, Uzm. Dr. Emel. “Patent Duktus Arteriyozus Yönetimi”. Klinik Tıp Pediatri Dergisi 9/4 (Temmuz 2017), 33-37.
JAMA Okulu UDE. Patent Duktus Arteriyozus Yönetimi. Pediatri. 2017;9:33–37.
MLA Okulu, Uzm. Dr. Emel. “Patent Duktus Arteriyozus Yönetimi”. Klinik Tıp Pediatri Dergisi, c. 9, sy. 4, 2017, ss. 33-37.
Vancouver Okulu UDE. Patent Duktus Arteriyozus Yönetimi. Pediatri. 2017;9(4):33-7.