Controversies around treatment of the open duct [electronic resource] /
Poets, Christian.editor.
Koehne, Petra.editor.
Franz, Axel.editor.
The patent ductus arteriosus continues to pose a considerable challenge to clinicians and scientists alike. Why does it close spontaneously in most infants but remain open in others? How best can we select those infants who are most likely to benefit from treatment, i.e. are there echocardiographic criteria that would help in defining a more selective treatment approach? Would it be better to take an aggressive approach and prescribe prophylactic treatment to all extremely immature infants ‑ and if so, what is the best way to define such a subgroup? Or should we be more restrictive in defining treatment indications and adopt a 'wait and see' policy in most, if not all, premature infants? Finally, are there data to suggest that one of the treatment approaches that are available to close the patent ductus arteriosus is superior to the other? This book deals with these questions and tries to give some answers, based on the evidence currently available. It is intended for neonatologists, pediatric cardiologists and researchers.
Description based upon print version of record.
Preface; Table of Contents; List of Contributors; 1Ductal Closure After Birth - Morphological Aspects and New Insights; Introduction; Developmental Background; Ductal Maturation; Postnatal Anatomical Remodelling; PDA in Premature Infants - Morphologic Aspects; Signalling Related to Ductal Closure; Genetic and Environmental Risk Factors for PDA in Premature Infants; Prevention of DA Closure in Neonates with CHD; Conclusion; References; 2Treatment Results After Ductal Closure in Extremely Low Gestational Age Infants; Factors Determining Outcome of Very Low Birth Weight Infants
Impact of Patent Ductus Arteriosus Intervention for OutcomeProphylactic Cyclooxygenase Inhibitor Treatment; Prophylactic Ligation of the Ductus Arteriosus; Therapeutic Use of Cyclooxygenase Inhibitors for Patent Ductus Arteriosus Intervention; Surgical Ligation of Patent Ductus Arteriosus After Failed Pharmacological Intervention; Conclusions and Perspectives; References; 3Echocardiographic Assessment of the Patent Ductus Arteriosus in the Preterm Infant; Introduction; Doppler Ultrasound; Is the Ductus Arteriosus Patent?; How Wide is the Ductus Arteriosus?
What is the Direction and Velocity of the Shunt?What is the Hemodynamic Significance of the PDA?; Impact of the Ductal Shunt on the Lungs; Impact of the Ductal Shunt on the Systemic Circulation; Prediction of Spontaneous and Therapeutic Ductal Closure; Summary; References; 4Evaluation of the Open Duct Using Systolic Time Intervals and Doppler Sonography of Peripheral Arteries; Systolic Time Intervals; Definitions of the Ejection Time and the Pre-Ejection Period; How to Measure the Ejection Time and the Pre-Ejection Period?; Reference Ranges for the Ejection Time and the Pre-Ejection Period
Doppler Sonographic Blood Flow Parameters of Peripheral ArteriesMeasurement of Blood Flow Parameters of Peripheral Arteries Descending Aorta; Anterior Cerebral Artery; Superior Mesenteric Artery; Renal Artery; Summary and Conclusion; References; 5Competitive Inhibition of Bilirubin-Albumin Binding by Ibuprofen; Introduction; Hyperbilirubinemic Encephalopathy in Preterm Infants; Measurement of Unbound Bilirubin Concentrations; Bilirubin-Albumin Binding and Bilirubin Displacers; IBU Concentrations During Treatment of hsPDA; Bilirubin-Albumin Displacing Effect of IBU in Vitro
Bilirubin-Albumin Displacing Effect of IBU in VivoConclusions; References; 6Controversies Around Treatment of the Open Duct; Introduction; Fluid Restriction for PDA?; Which Drug Should Be Used?; A Choice Based on Side Effects?; Optimal Dosing of Indomethacin and Ibuprofen?; Is There a Role for Prophylaxis?; Conclusion; References; 7High-Dose Therapywith Cyclooxygenase-Inhibitors for SymptomaticPersistent DuctusArteriosus in Preterms; Treatment Options; Pharmacological Treatment; High-Dose Therapy with Indomethacin; Effectiveness and Side Effects of EscalatingHigh-Dose Therapy
Long-Term Follow-up
Includes bibliographical references and index.
The patent ductus arteriosus continues to pose a considerable challenge to clinicians and scientists alike. Why does it close spontaneously in most infants but remain open in others? How best can we select those infants who are most likely to benefit from treatment, i.e. are there echocardiographic criteria that would help in defining a more selective treatment approach? Would it be better to take an aggressive approach and prescribe prophylactic treatment to all extremely immature infants ‑ and if so, what is the best way to define such a subgroup? Or should we be more restrictive in defining treatment indications and adopt a 'wait and see' policy in most, if not all, premature infants? Finally, are there data to suggest that one of the treatment approaches that are available to close the patent ductus arteriosus is superior to the other? This book deals with these questions and tries to give some answers, based on the evidence currently available. It is intended for neonatologists, pediatric cardiologists and researchers.
Medicine.
Obstetrics.
Pediatrics.
Medicine/Public Health, general.
Obstetrics/Perinatology/Midwifery.
Pediatrics.