What topical medications are used for patent ductus arteriosus

What topical medications are used for patent ductus arteriosus? Nowadays, more and more children suffer from patent ductus arteriosus, which poses a threat to children's health. Because this disease occurs in the heart, it needs timely treatment. So, what topical medications are used to treat patent ductus arteriosus?

Patent ductus arteriosus (PDA) is one of the common types of congenital heart disease in children, accounting for about 15% of the total number of congenital heart diseases. The passive opening of the ductus arteriosus during the fetal period is an important channel for blood circulation. Patent ductus arteriosus is common in premature infants, with an incidence of 80% in infants born before 28 weeks of gestation. It functionally closes about 15 hours after birth and should be completely closed anatomically one year after birth. If it remains open and produces pathological and physiological changes, it is called patent ductus arteriosus.

1. Treatment of patent ductus arteriosus in premature infants

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