Drug treatment of patent ductus arteriosus in newborns

Patent ductus arteriosus (PDA) is a common heart defect in newborns, and drug therapy is an important means of early intervention. Drug therapy helps close the patent ductus arteriosus by using prostaglandin inhibitors such as indomethacin, ibuprofen, and acetylsalicylic acid. These drugs inhibit prostaglandin synthesis, promote ductal contraction and closure, and are usually most effective when used early after birth.

1. Indomethacin is one of the first choice drugs for the treatment of PDA. It inhibits cyclooxygenase and reduces the synthesis of prostaglandins, thereby promoting the closure of the ductus arteriosus. The dose and course of indomethacin need to be adjusted according to the weight and clinical response of the newborn, and usually requires multiple administrations.

2. Ibuprofen is another commonly used prostaglandin inhibitor, and its mechanism of action is similar to that of indomethacin. The advantage of ibuprofen is that it has relatively few side effects, especially for newborns who are intolerant to indomethacin. Ibuprofen can be administered orally and intravenously, and the specific regimen is determined by the doctor based on the child's condition.

3. Aspirin acetylsalicylate can also be used to treat PDA in some cases. Although it is used less frequently, in certain cases, aspirin can assist in closing the ductus arteriosus by inhibiting prostaglandin synthesis. When using it, the child's coagulation function should be closely monitored to avoid the risk of bleeding.

The success rate of drug treatment is closely related to the age, weight and degree of patent ductus of the newborn. Early diagnosis and timely intervention are the key to improving the treatment effect. During drug treatment, the heart function, renal function and coagulation indexes of the child need to be closely monitored to ensure the safety of medication.

For newborns who are not responsive to drug treatment or have contraindications, surgical treatment may need to be considered. Surgical methods include ductal ligation and ductal occlusion, and the specific choice depends on the child's condition and medical conditions. Surgical treatment is usually performed after drug treatment has failed to ensure the best treatment effect.

Medical treatment for patent ductus arteriosus in newborns is an effective and relatively safe intervention. Proper use of prostaglandin inhibitors can help most children successfully close the ductus arteriosus and improve heart function. Parents should actively cooperate with the doctor's treatment plan and follow up regularly to ensure the healthy recovery of the child.