What are the principles of treatment for patent ductus arteriosus in newborns?

The treatment principles for patent ductus arteriosus in newborns include observation, drug therapy, and surgical treatment. The specific choice depends on the severity of the disease and the health of the child. Mild cases may not require immediate intervention, while moderate to severe cases require drug or surgical treatment.

1. Observation and monitoring

For newborns with mild PDA, doctors may recommend regular observation and monitoring. The ductus arteriosus usually closes naturally within a few days to a few weeks after birth. During this time, doctors will evaluate the closure of the ductus with tests such as echocardiography and monitor the child's heart and lung function. If the PDA does not cause obvious problems for the child, no special treatment may be needed.

2. Drug treatment

For children with moderate patent ductus arteriosus or symptoms, drug treatment is the first choice. Commonly used drugs include:

Indomethacin: Promotes ductal contraction and closure by inhibiting prostaglandin synthesis.

Ibuprofen: Its mechanism of action is similar to that of indomethacin and it is often used in premature infants.

Acetaminophen: Can be used as an alternative medication in some cases.

Drug treatment is usually carried out in the neonatal intensive care unit (NICU), and the drug effects and side effects need to be closely monitored.

3. Surgical treatment

For children who are not responding to drug treatment or whose condition is severe, surgical intervention is necessary. Common surgical procedures include:

Duct ligation: Direct ligation of a patent ductus arteriosus during thoracotomy.

Minimally invasive occlusion: Through catheter intervention technology, an occluder is implanted in the patent ductus arteriosus.

Thoracoscopic surgery: less trauma, suitable for some children.

The choice of surgery should be based on the child's specific situation and medical condition, and recovery should be closely monitored after surgery.

The treatment of patent ductus arteriosus in newborns requires a personalized plan based on the severity of the disease and the health status of the child. Mild cases can be solved through observation and monitoring, moderate cases can be treated with medication, and severe cases require surgical intervention. Regardless of the treatment method, it must be carried out under the guidance of a professional doctor, and regular follow-up must be performed to ensure the healthy growth of the child.