Anikin I. Optimization of intensive care of preterm infants with critical weight associated with patent ductus arteriosus

The research devotes to characteristics of patent ductus arteriosus syndrome in preterm infants with low and very low birth weight, and improvement of intensive therapy of anomalies which are hemodynamically significant. The features of respiratory status which changed under the influence of defect were investigated. Symptoms of CNS depression were found in 61.67% of infants, reduced tolerance to food - in 28.33% and acute renal failure - in 51.67% of newborns with syndrome which was investigated. The peculiarities of central, cerebral, and renal hemodynamics status in preterm infants with critical weight associated with patent ductus arteriosus were studied. Regularity and nature of above-mentioned disorders were defined. Correlation analysis of the dependence degree of the studied hemodynamic parameters on left-right shunt through the ductus arteriosus was performed. This correlation appeared to be moderate. After comparison of clinical and laboratory parameters of internal's dysfunction to the Doppler findings after PDA infants examination it is possible to ground new predictors of hemodynamic significance of defects, and to develop modern principles of diagnostics and intensive therapy of this pathology. On the basis of research results basic and supplementary criteria of hemodynamic significance of defect were determined. The algorithm of diagnostics and treatment of preterm infants with PDA was worked up taking into consideration the correlation and using criteria of hemodynamic significance of defect. The correction of defect in 61.67% cases was reached owing to this algorithm. The regularity of reconstruction of respiratory status and central and peripheral hemodynamic after arrest of PDA blood shunting was studied.