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What is A premature infant is born with a patent ductus aeriosus. In closure can be stimulated by administration of: and explain in detail?
Patent ductus aeriosus represents persistent patency of the vessel. The ductus aeriosus usually closes within 2 or 3 days after bih and becomes the ligamentum aeriosum. Constriction of the ductus postnatally involves a complex interaction of increased paial pressure of oxygen, decreased circulating prostaglandin E2 (PGE2), decreased PGE2 ductal receptors, and decreased pressure within the ductus. Subsequent vessel-wall hypoxia of the ductus promotes fuher closure through inhibition of prostaglandin and nitric oxide within the ductal wall. For premature infants, treatment with indomethacin, a prostaglandin inhibitor, is usually the first-line therapy. Ibuprofen has achieved closure rates equivalent to those of indomethacin with less renal toxicity. When PDA fails to close with indomethacin or for term infants with a persistent PDA, surgical or interventional closure is recommended. Ref: Brown D.W., Fulton D.R. (2011). Chapter 83. Congenital Hea Disease in Children and Adolescents. In V. Fuster, R.A. Walsh, R.A. Harrington (Eds), Hurst's The Hea, 13e.