Singh Yogen, Mikrou Paraskevi
Department of Neonatology and Paediatric Cardiology, Cambridge University Hospitals NHS Foundation Trust and University of Cambridge, Cambridge, UK.
Health Education England (West Midlands), Birmingham, UK.
Arch Dis Child Educ Pract Ed. 2018 Jun;103(3):137-140. doi: 10.1136/archdischild-2017-313654. Epub 2017 Nov 21.
Congenital heart disease (CHD) remains a leading cause of infant mortality, which is even higher in infants with undiagnosed duct-dependent CHDs. Up to 39%-50% of infants with critical CHD are being discharged undiagnosed from the hospital. Infants with duct-dependent critical CHD remain well during the fetal period and may deteriorate when the ductus arteriosus (commonly called 'duct') closes after birth. It is critical to open or maintain ductus arteriosus patent in infants with duct-dependent CHDs. Prostaglandin E1 (alprostadil marketed as 'Prostin VR ') and prostaglandin E2 (dinoprostone) are used to maintain a patent ductus arteriosus and the dose of medication depends on the clinical presentation. Delay in starting prostaglandin infusion can have deleterious effects on infants and can even lead to death. These infants often present as an emergency, and professionals caring for these infants need to have a good understanding of these conditions and medications used for ductal patency.
先天性心脏病(CHD)仍然是婴儿死亡的主要原因,在未诊断出的依赖导管的先天性心脏病婴儿中死亡率更高。高达39%-50%的患有严重先天性心脏病的婴儿在出院时未被诊断出来。患有依赖导管的严重先天性心脏病的婴儿在胎儿期状况良好,但出生后动脉导管(通常称为“导管”)关闭时可能会恶化。对于患有依赖导管的先天性心脏病的婴儿,开放或维持动脉导管通畅至关重要。前列腺素E1(以“Prostin VR”销售的前列地尔)和前列腺素E2(地诺前列酮)用于维持动脉导管通畅,药物剂量取决于临床表现。延迟开始前列腺素输注可能对婴儿产生有害影响,甚至导致死亡。这些婴儿通常作为急症出现,照顾这些婴儿的专业人员需要充分了解这些病症以及用于维持导管通畅的药物。