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经皮动脉导管未闭封堵术在早产儿中的应用:巴西的初步经验。

Percutaneous Closure of Ductus Arteriosus in Preterm Babies: The Initial Brazilian Experience.

机构信息

Instituto de Cardiologia/Fundação Universitária de Cardiologia (IC/FUC), Porto Alegre, RS - Brasil.

Real Hospital Português de Beneficência em Pernambuco, Recife, PE - Brasil.

出版信息

Arq Bras Cardiol. 2022 Sep;119(3):460-467. doi: 10.36660/abc.20210818.

Abstract

BACKGROUND

The presence of patent ductus arteriosus can be as high as 50% in preterm babies. Hemodynamically significant patent ductus arteriosus is a common cause of delayed weaning of respiratory support and an important risk factor of necrotizing enterocolitis, intraventricular hemorrhage, and bronchopulmonary dysplasia in this population.

OBJECTIVE

The aim of this study is to describe an initial experience of percutaneous closure of the ductus arteriosus in preterm infants weighing less than 2 kg.

METHODS

This was a prospective study, comprised of 14 consecutive patients submitted to percutaneous closure of ductus arteriosus between March 2020 and February 2021 in 6 institutions in Brazil.

RESULTS

Mean gestational age was 28.45±3.14 weeks, mean age at the procedure was 38.85±17.35 days and mean weight was 1.41 ±0.41 kg; 79% of the patients were under mechanical ventilation, and 79% had been submitted, on average, to a 1.5 cycle of non-steroidal anti-inflammatory drugs. Most patients were weaned off of mechanical ventilation in a mean of 12.6 ±7.24 days after the procedure. Success rate was 100%. No procedure-related mortality was observed.

CONCLUSION

This study concluded that percutaneous closure of ductus arteriosus in premature babies below 2 kg has satisfactory results and a low complication rate in this study sample.

摘要

背景

早产儿动脉导管未闭的发生率可高达 50%。血流动力学意义重大的动脉导管未闭是导致早产儿呼吸支持脱机延迟的常见原因,也是该人群发生坏死性小肠结肠炎、颅内出血和支气管肺发育不良的重要危险因素。

目的

本研究旨在描述对体重小于 2 公斤的早产儿行动脉导管未闭经皮封堵术的初步经验。

方法

这是一项前瞻性研究,包括 2020 年 3 月至 2021 年 2 月间巴西 6 家机构的 14 例连续接受经皮动脉导管未闭封堵术的患者。

结果

平均胎龄为 28.45±3.14 周,平均手术年龄为 38.85±17.35 天,平均体重为 1.41±0.41kg;79%的患者接受机械通气,79%的患者平均接受了 1.5 个周期的非甾体类抗炎药治疗。大多数患者在术后平均 12.6±7.24 天成功脱机。成功率为 100%。未观察到与操作相关的死亡。

结论

本研究表明,在体重低于 2 公斤的早产儿中,经皮动脉导管未闭封堵术具有满意的结果,且在本研究样本中并发症发生率低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d4a/9438535/4c4a067419f8/0066-782X-abc-119-03-0460-gf01.jpg

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