[Management of persistent ductus arteriosus in the newborn with respiratory insufficiency]. / Manejo del conducto arterioso persistente en el recién nacido con insuficiencia respiratoria.

Sixteen newborn babies with severe respiratory distress and patent ductus arteriosus with congestive heart failure are presented. Fifteen of them were premature and one at full term. Management consisted of the accepted medical and ventilatory aids such as digitalis, diuretics, ventilators, etc. Thirteen cases were given indomethacin with clinical closure in five of them (38%). Ten cases underwent surgical closure with 30% mortality. It is recommended that these patients be given indomethacin inicially; if there is no response in 36 hours surgical closure of the duct should be performed prior to progressive deterioration and eventual death.

[Early mechanical respiration with prolonged inspiration in the treatment of acute respiratory insufficiency in the newborn]. / Ventilación mecánica temprana con inspiración prolongada, en el tratamiento de la insuficiencia respiratoria aguda del recién nacido.

The experience at the Servicio de Medicina Perinatal Pediátrica of the Centro Hospitalario "20 de Noviembre" of the ISSSTE is reported on the application of a ventilatory assistance criterion to treat the severe respiratory distress syndrome in the newborn. Early application of intermittent mechanical ventilation (IMV) is established to avoid clinical impairment. The mechanical ventilator is used in such a way that without withdrawing therapeutic effectiveness, it may cut down to a minimum complications derived from the use of IMV. The results show increase in survivorship, specially among the lower weight population and less complications than with the previous management method, in spite of a 70% increase in the use of IMV.