Anesthetic management of catheter-based patent ductus arteriosus closure in neonates weighing <3 kg: A Retrospective Observational Study.
Paediatr Anaesth
; 30(4): 506-510, 2020 04.
Article
em En
| MEDLINE
| ID: mdl-32040230
ABSTRACT
BACKGROUND:
The patent ductus arteriosus is a cardiac lesion commonly found in premature neonates. Though surgical closure via thoracotomy is the most definitive treatment option, it is associated with significant morbidity. New catheter-based closure options offer a potentially safer alternative treatment, even in premature neonates. However, no literature reports the anesthetic techniques, challenges, and risks associated with this procedure in this population.AIM:
This study documents the anesthetic challenges and potential complications associated with the management of catheter-based closure of the ductus arteriosus in neonates under 3 kg.METHODS:
This single-center, retrospective study examined patients who underwent catheter-based ductus arteriosus closure between August 2015 and February 2019. A clinical protocol for anesthetic management of these patients was utilized throughout the study period. Clinical outcomes considered were new hemodynamic instability or vasoactive medication requirements, hypothermia, prolonged intubation (>3 days postoperatively), postprocedure acute kidney injury, perioperative red blood cell transfusion, and accidental extubation.RESULTS:
Seventy-six neonates underwent 78 procedures. No patient developed perioperative hemodynamic instability, vasoactive medication requirements, or acute kidney injury. Four patients (5%) required red blood cell transfusion, two (3%) became hypothermic, and one (1%) was accidentally extubated. Closure was achieved in 73 patients (96%) on the first attempt. However, 17 patients (40%) required prolonged periods of mechanical ventilation following the procedure.CONCLUSION:
Despite multiple clinical and logistical challenges, anesthetic risk associated with catheter-based PDA closure in small neonates can be effectively managed through standardized and multidisciplinary care.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Cateterismo Cardíaco
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Permeabilidade do Canal Arterial
/
Anestesia
Tipo de estudo:
Guideline
/
Observational_studies
/
Risk_factors_studies
Limite:
Female
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Humans
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Male
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Newborn
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article