Patent ductus arteriosus (PDA)
Introduction
Clinically significant PDA is quite frequent in very sick
preterm infants with RDS, prolonged hypoxia and acidosis.
Etiology
- ductus arteriosus is a conduit between the pulmonary
artery and aorta
- oxygen-induced constriction of the ductus occurs within
12 hours after birth, anatomical closure is observed about
10 — 20 days of age. The ductus in preterm infants
is less responsibe to this oxygen effect.
Clinical signs
- continuous murmur
- left to right shunt — increased pulmonary
blood flow, decrease in systemic blood flow
- renal hypoperfusion (uremia, decreased urine output)
- intestinal hypoperfusion (feeding intolarance, increased risk of NEC)
- hypotension
- therapy: decrease of fluid intake,
indomethacin, surgical ligation if necessary
