Neonatal patent ductus arteriosus accompanied by acute heart failure and pulmonary edema: a case report and literature review
10.3969/j.issn.1008-9691.2019.04.026
- VernacularTitle:新生儿动脉导管未闭合并急性心力衰竭和肺水肿1例并文献复习
- Author:
Yanzhang YANG
1
;
Li WANG
;
Yanfang YANG
;
Fengqin CHEN
;
Lijin XU
Author Information
1. 河北省人民医院儿科
- Keywords:
Patent ductus arteriosus;
Acute heart failure;
Pulmonary edema;
Neonate;
Vasodilator
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2019;26(4):478-480
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the feasibility and safety of using vasodilators in the treatment of neonates with patent ductus arteriosus (PDA) accompanied by acute heart failure and pulmonary edema. Methods The clinical data of a case of neonatal PDA accompanied by severe cardiac insufficiency and pulmonary edema in Department of Intensive Care Unit (ICU) of Hebei General Hospital, and the neonate's hemodynamic characteristics and the efficacy and adverse reactions of phentolamine, a vasodilator, in the treatment of PDA were retrospectively analyzed. Results In this neonate, on the 8th day after birth and the improvement of pulmonary hyaline membrane disease, the respiratory distress occurred again, which was related to the severe cardiac dysfunction caused by the opening of PDA. Phentolamine was given on the basis of routine treatment to reduce systemic circulatory resistance. Two hours later, the respiratory distress was relieved significantly, that was presumably related to the decline of the left to right shunt volume through the PDA. There were no adverse reactions such as blood pressure reduction and coronary insufficiency. Conclusion Neonatal PDA is easily to be complicated with severe cardiac insufficiency, and vasodilators can reduce systemic circulatory resistance, reduce left to right shunt volume through the ductus arteriosus, and reverse the acute cardiac insufficiency and pulmonary edema, the therapeutic effect of vasodilators is remarkable, safe and reliable in neonatal PDA.
