RESUMEN
Although the prophylactic administration of indomethacin in extremely low-birth weight infants reduces the frequency of patent ductus arteriosus and severe intraventricular hemorrhage, it does not appear to provide any long-term benefit in terms of survival without neurosensory and cognitive outcomes. Considering the increased drug-induced reduction in renal, intestinal, and cerebral blood flow, the use of prophylaxis cannot be routinely recommended in preterm neonates. However, a better understanding of the genetic background of each infant may allow for individualized prophylaxis using NSAIDs and metabolomics.
Asunto(s)
Inhibidores de la Ciclooxigenasa/uso terapéutico , Conducto Arterioso Permeable/prevención & control , Ibuprofeno/uso terapéutico , Indometacina/uso terapéutico , Enfermedades del Prematuro/prevención & control , Humanos , Recien Nacido con Peso al Nacer Extremadamente Bajo , Recién Nacido , Hemorragias Intracraneales/prevención & control , LigaduraRESUMEN
Postnatal closure of the ductus arteriosus is crucial in the circulatory adaptation of the newborn to extrauterine life. In recent years, many studies have been performed to improve our understanding of both the physiology of the ductus arteriosus in the fetus and newborn, and the mechanisms underlying persistent ductal patency in the preterm infant. The pharmacological treatment of patent ductus arteriosus (PDA) remains a controversial issue. This article reviews the recent literature on the pathogenesis and clinical management of PDA in the preterm infant.
Asunto(s)
Conducto Arterioso Permeable/etiología , Conducto Arterioso Permeable/terapia , Enfermedades del Prematuro/etiología , Enfermedades del Prematuro/terapia , Conducto Arterioso Permeable/embriología , Feto/patología , Humanos , Recién Nacido , Recien Nacido Prematuro , Modelos BiológicosRESUMEN
Although the prophylactic administration of indomethacin in extremely low-birth weight infants reduces the frequency of patent ductus arteriosus and severe intraventricular hemorrhage, it does not appear to provide any long-term benefit in terms of survival without neurosensory and cognitive outcomes. Considering the increased drug-induced reduction in renal, intestinal, and cerebral blood flow, the use of prophylaxis cannot be routinely recommended in preterm neonates. However, a better understanding of the genetic background of each infant may allow for individualized prophylaxis using NSAIDs and metabolomics.