The choice of tactics of treatment of patent ductus arteriosus in newborns with low and the critical birth weight

Abstract

Questions diagnosis and tactics of treatment of patent ductus arteriosus in newborns with low and critical birth weight today are relevant to the practice of neonatal intensive care. The most unresolved issue is to identify the signs of hemodynamic significance of vice that often requires surgery. Thus, the objectification of assessing the severity of the newborn state with the CAP and the development of algorithms for early diagnosis and treatment is an actual problem.Purpose of the study. Develop and implement a diagnostic and treatment algorithm PDA in infants with low and critical body weight.Material and methods. During the years 2010-2013 was conducted a prospective controlled study. Study group consisted of 60 children with left-right shunt through the ductus arteriosus. A control group includ 30 premature newborn without blemish, a representative for gestational age and sex. Term gestation of newborn was 28,0 ± 2,0 weeks, the average weight of 1168,0 ± 377,0 grams.Results of the study. Was researching features of the central condition, brain, renal hemodynamics in neonates with critical body weight on the background of patent ductus arteriosus . The regularities and nature of the aforementioned disorders. Comparison of the clinical and laboratory characteristics of the organ dysfunctions with Doppler parameters obtained during the examination of the cardiovascular system of children with PDA allowed to substantiate new predictors of hemodynamic significance of vice, and to develop modern principles of diagnosis and intensive therapy of the disease. Based on these research was realized the basic and additional criteria for the hemodynamic significance of vice, which are summarized in the diagnosis and treatment algorithm.Conclusions. The application of the developed algorithm of diagnosis and treatment of PDA in infants with low and very low birth weight possible to achieve correction of the defect at 61.67%, which is 16,67% (p <0,05) more compared to traditional approaches to treatment.