Abstract
Hemodynamics with hypervolemia of pulmonary circulation in premature patients with hemodynamically significant
patent ductus arteriosus (PDA) can result in severe complications and even death.
Objective. To justify the approach to treatment of neonates with low weight and hemodynamically significant
patent ductus arteriosus.
Material and methods. Neonatal ICU of Saint-Petersburg City Children's Hospital №1 receives about 1000 patients
every year. One third of them have the body weight of less than 1500 g. 317 patients with weight of less than 1500 g
and 53 infants with body weight of less than 750 g were treated in intensive care unit in 2010. Surgical treatment
of patent ductus arteriosus in premature infants is performed only by staff of City Children's Hospital №1. 74 surgeries
for PDA clipping were performed in patients from ICU of City Children Hospital and 29 operated patients were
from the other hospitals.
Results. The efficiency of pharmacological closure of PDA with Pedea® injection in intensive care unit is linear to
the term of gestation. The effectiveness of pharmacological closure in patients born at 27 weeks gestation did not
exceed 20%. The effectiveness of pharmacological treatment in infants born at 28-30 weeks gestation was 40%, and
at 31-34 weeks it was more than 70%. Consequently, the surgical activity was higher in patients with low body
weight. Hospital mortality was 3.2% (n=16). It was not associated with the surgical intervention. There were no
infectious complications associated with surgery.
Conclusions. Surgical closure of PDA in premature infants is the simple and effective operation associated with
minimal risk.
References
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