HIỆU QUẢ ĐÓNG ỐNG ĐỘNG MẠCH BẰNG THUỐC Ở TRẺ SƠ SINH NON THÁNG TẠI BỆNH VIỆN ĐA KHOA NINH THUẬN NĂM 2024

Abstract

Introduction: Patent ductus arteriosus (PDA) is one of the most common congenital heart defects, accounting for 5%-10% of all congenital heart disease in term infants. The occurrence of PDA is inversely related to gestational age and weight, with an even greater incidence in preterm infants. Objective: To determine the success rate of PDA closure after intravenous paracetamol therapy in preterm infants and to analyze clinical and echocardiographic factors associated with successful closure. Method: A prospective observational study was conducted on preterm infants admitted to the Neonatal Intensive Care Unit of Ninh Thuan General Hospital from December 2023 to September 2024. Eligible infants were diagnosed with PDA and indicated for medical closure. All patients received intravenous paracetamol, and echocardiography was performed three days after treatment initiation to assess ductal closure. Results: A total of 25 preterm infants were included, of whom 64% were male. The proportions of very preterm (<32 weeks) and extremely preterm (<28 weeks) infants were 48% and 12%, respectively. The overall PDA closure rate after intravenous paracetamol therapy was 84%. Before treatment, 11 infants required mechanical ventilation; after treatment, 9/11 (81.8%) were successfully extubated and switched to NCPAP, while 2 continued on mechanical ventilation. Ductal diameter was significantly associated with successful PDA closure (p < 0.05). Conclusion: Intravenous paracetamol appears to be a safe and effective option for PDA closure in preterm infants, with a high success rate and good short-term respiratory improvement.