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我们应该“消除”早产儿的动脉导管未闭分流吗？一篇叙述性综述。

Should we "eliminate" PDA shunt in preterm infants? A narrative review.

作者信息

Surak Aimann, Sidhu Amneet, Ting Joseph Y

机构信息

Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.

Division of Neonatal-Perinatal Medicine, Department of Pediatrics, McMaster University, Hamilton, ON, Canada.

出版信息

Front Pediatr. 2024 Feb 6;12:1257694. doi: 10.3389/fped.2024.1257694. eCollection 2024.

DOI:10.3389/fped.2024.1257694
PMID:38379909
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10876852/
Abstract

The patent ductus arteriosus frequently poses a significant morbidity in preterm infants, subjecting their immature pulmonary vascular bed to substantial volume overload. This, in turn, results in concurrent hypoperfusion to post-ductal organs, and subsequently alters cerebral blood flow. In addition, treatment has not demonstrated definitive improvements in patient outcomes. Currently, the optimal approach remains a subject of considerable debate with ongoing research controversy regarding the best approach. This article provides a comprehensive review of existing literature.

摘要

动脉导管未闭在早产儿中常常会引发严重的发病情况，使其未成熟的肺血管床承受大量的容量负荷。这进而导致导管后器官同时出现灌注不足，随后改变脑血流量。此外，治疗并未在患者预后方面显示出明确的改善。目前，最佳治疗方法仍是一个备受争议的话题，关于最佳方法的研究仍存在争议。本文对现有文献进行了全面综述。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3eb6/10876852/cfc22abd9ed1/fped-12-1257694-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3eb6/10876852/9d68d1e3060d/fped-12-1257694-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3eb6/10876852/cfc22abd9ed1/fped-12-1257694-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3eb6/10876852/9d68d1e3060d/fped-12-1257694-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3eb6/10876852/cfc22abd9ed1/fped-12-1257694-g002.jpg

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Should we "eliminate" PDA shunt in preterm infants? A narrative review.我们应该“消除”早产儿的动脉导管未闭分流吗？一篇叙述性综述。
Front Pediatr. 2024 Feb 6;12:1257694. doi: 10.3389/fped.2024.1257694. eCollection 2024.
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本文引用的文献

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Reproducibility of the EL-Khuffash PDA severity score and PDA diameter measurements in extremely preterm infants.EL-Khuffash早产儿动脉导管未闭严重程度评分及动脉导管未闭直径测量在极早产儿中的可重复性。
Early Hum Dev. 2023 Sep;184:105832. doi: 10.1016/j.earlhumdev.2023.105832. Epub 2023 Jul 26.
2
Early neurodevelopmental outcomes of extreme preterm infants exposed to paracetamol: a retrospective cohort study.接受对乙酰氨基酚治疗的极早产儿的早期神经发育结局：一项回顾性队列研究。
Pediatr Res. 2023 Nov;94(5):1714-1719. doi: 10.1038/s41390-023-02649-4. Epub 2023 May 17.
3
Interventions for patent ductus arteriosus (PDA) in preterm infants: an overview of Cochrane Systematic Reviews.
早产儿动脉导管未闭（PDA）的干预措施：Cochrane 系统评价概述。
Cochrane Database Syst Rev. 2023 Apr 11;4(4):CD013588. doi: 10.1002/14651858.CD013588.pub2.
4
Combination pharmacotherapy for patent ductus arteriosus: Rationale and evidence.动脉导管未闭的联合药物治疗：原理和证据。
Semin Perinatol. 2023 Mar;47(2):151720. doi: 10.1016/j.semperi.2023.151720. Epub 2023 Mar 2.
5
Impact of early screening echocardiography and targeted PDA treatment on neonatal outcomes in "22-23" week and "24-26" infants.早筛超声心动图和目标性动脉导管未闭治疗对 22-23 周和 24-26 周婴儿新生儿结局的影响。
Semin Perinatol. 2023 Mar;47(2):151721. doi: 10.1016/j.semperi.2023.151721. Epub 2023 Mar 5.
6
Expectant Management or Early Ibuprofen for Patent Ductus Arteriosus.期待治疗或早期布洛芬治疗动脉导管未闭。
N Engl J Med. 2023 Mar 16;388(11):980-990. doi: 10.1056/NEJMoa2207418. Epub 2022 Dec 6.
7
Patent Ductus Arteriosus and Development of Bronchopulmonary Dysplasia-associated Pulmonary Hypertension.动脉导管未闭与支气管肺发育不良相关肺动脉高压的发生。
Am J Respir Crit Care Med. 2023 Apr 1;207(7):921-928. doi: 10.1164/rccm.202203-0570OC.
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Patent Ductus Arteriosus: A Contemporary Perspective for the Pediatric and Adult Cardiac Care Provider.动脉导管未闭：儿科和成人心脏护理提供者的当代视角。
J Am Heart Assoc. 2022 Sep 6;11(17):e025784. doi: 10.1161/JAHA.122.025784. Epub 2022 Sep 3.
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Fluid and electrolyte management in preterm infants with patent ductus arteriosus.动脉导管未闭早产儿的液体和电解质管理。
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Respir Care. 2022 May;67(5):594-606. doi: 10.4187/respcare.09489.