Aleksandrovich Yu S, Khubulava G G, Chupaeva O Yu, Naumov A B, Marchenko S P, Melashenko T B, Pshenisnov K V, Li A G
Anesteziol Reanimatol. 2016 Nov;61(6):438-442.
Patent ductus arteriosus (PDA) is one of the most common pathological conditions within the neonatal period Functioning of hemodynamically significant patent ductus arteriosus can cause a development ofvarious complications. This is why the earliest possible drug therapy or surgery is required in order to eliminate this fetal communication.
to study the efficacy and safety of acetaminophen administering to infants with low birth weight for medical obliteration of hemodynamically significant ductus arteriosus.
The study included 16 infants with gestational age up to 29 weeks and birth weight less than 1200 g, the average birth weight was 980±230 g and gestation was 26,4±1,4 weeks. The average age of the observable patients at the moment of the beginning of the acetaminophen therapy was 56±6 h. Ductus arteriosus diameter was 3,75±1,25 mm. All the children underwent drug obliteration of the PDA through the intravenous acetaminophen administering. 15 mg / kg of the drug was given every 6 hours for three days. The full treatment course included 12 injections.
The expected effect (closing of the ductus arteriosus) was achieved in 14 (87.5%) children undergoing the drug therapy. Two children with the birth weight of 1000 g and 1200 g remained with the ductus arteriosus open, but the signs of the left heart volume overload decreased significantly. To achieve a clinical benefit, it took 11 injections of the drug, on average. The children with the ongoing therapy were receiving enteral nutrition with the standard dosages corresponding to their age. No complications of the urinary tract, gastrointestinal tract or haemostatic system were registered.
Using acetaminophenfor medical obliteration of the ductus arteriosus is a highly effective and safe method of treatment that has to be used in routine clinical practice. Dosing of the drug is easy to control and change, hence it is possible to cancel the drug administering as soon as the required result is achieved so as to minimize any complications.
动脉导管未闭（PDA）是新生儿期最常见的病理状况之一。具有血流动力学意义的动脉导管未闭的功能可导致各种并发症的发生。这就是为什么需要尽早进行药物治疗或手术以消除这种胎儿期通道。
研究对低体重婴儿给予对乙酰氨基酚以药物性闭塞具有血流动力学意义的动脉导管未闭的疗效和安全性。
该研究纳入了16例胎龄达29周且出生体重低于1200g的婴儿，平均出生体重为980±230g，孕周为26.4±1.4周。在开始对乙酰氨基酚治疗时，观察对象的平均年龄为56±6小时。动脉导管直径为3.75±1.25mm。所有儿童均通过静脉给予对乙酰氨基酚进行动脉导管未闭的药物性闭塞。每6小时给予15mg/kg药物，共给药三天。整个治疗疗程包括12次注射。
接受药物治疗的14名（87.5%）儿童达到了预期效果（动脉导管闭合）。两名出生体重分别为1000g和1200g的儿童动脉导管仍未闭合，但左心容量超负荷的体征明显减轻。平均而言，药物注射11次后获得临床益处。正在接受治疗的儿童按与其年龄相应的标准剂量接受肠内营养。未记录到泌尿系统、胃肠道或止血系统的并发症。
使用对乙酰氨基酚进行动脉导管未闭的药物性闭塞是一种高效且安全的治疗方法，应在常规临床实践中使用。药物剂量易于控制和调整，因此一旦达到所需结果即可停止给药，以尽量减少任何并发症。
