How to use medicine for patent ductus arteriosus

How to use medicine for patent ductus arteriosus? For everyone, if you are sick, you want to take medicine to cure it quickly. The same is true for patent ductus arteriosus. It is a congenital disease in children and is harmful to the health of children. So, how to use medicine for patent ductus arteriosus?

1. Drug treatment

1. If the ductus arteriosus does not close at 24 s after indomethacin treatment, symptoms do not improve, and hypoxemia and hypercapnia persist despite adequate ventilation and oxygen support, and PC02>7.98kPa (60mmHg), simple ductus ligation should be performed urgently.

2. Indomethacin treatment: Patients who have not responded to anti-heart failure treatment should be given indomethacin by nasogastric feeding. One dose every 8 hours, for a total of 3 times. Before medication, the white blood cell count should be within the normal range, platelets should be no less than 60×109/L (60,000/mm3), urea nitrogen <20mg, and bilirubin <12mg. Urine volume, heart rate, appetite, and jaundice should be observed during medication. After medication, urea nitrogen, electrolytes, echocardiography, and chest X-ray should be reviewed. Adverse reactions of indomethacin include renal failure, hyponatremia, worsening jaundice, bone marrow suppression causing thrombocytopenia and coagulation disorders.

2. Medical treatment: prevent and treat infective endocarditis, respiratory tract infection and heart failure. For premature infants with patent ductus arteriosus, 0.2-0.3 mg/kg of indomethacin or 20 mg/kg of aspirin can be taken orally 4 times a day to inhibit prostaglandin synthesis and close the ductus. For older children or adults with pulmonary hypertension, tamponade or closure agents can be injected through the catheter to block the shunt.

The surgical mortality rate caused by massive bleeding during ductus arteriosus closure varies depending on the quality of the ductus wall, the surgical method used to close the ductus, and the level of surgeon skills, and should generally be less than 1%. Simple ductus ligation or clamping may result in ductus recanalization after surgery, and the recanalization rate is generally above 1%. The recanalization rate after padded ligation is lower than the former two.

The long-term effect of ductus arteriosus closure depends on whether there are secondary pulmonary vascular lesions before the operation and their extent. Patients who undergo surgery before pulmonary vascular lesions occur can fully recover and live as long as normal people. Patients with severe and irreversible pulmonary vascular lesions will still have high pulmonary vascular resistance and heavy right heart load after surgery, and the effect is poor.