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Treatment of Ductus Arteriosus
Background
What is the ductus arteriosus? When a baby is in the uterus he or she receives oxygen from the mother via the placenta and the umbilical cord. The lungs in utero are fluid filled and are not involved in gas exchange. Therefore, only 10 percent of the blood supply makes it to the lungs. The rest of the oxygen rich blood is shunted to the rest of the body through an opening in heart called foramen ovale, and a communication between pulmonary artery and Aorta called the ductus arteriosis. At birth the fluid in the lungs get absorbed as air fills the lungs. As this happens, overall pressure in the lungs decreases, which promotes increased blood flow into the lungs. In normal transition, this change in the direction of blood flow, and other biologicals markers such as specific phospholipids prompt the foramen ovale and ductus arteriosis to close. Essentially, this allows 100 percent of the blood to pass through the lungs where it dumps carbon dioxide and collects oxygen that will be distributed to every cell in the body.
What is a PDA? In some babies, the ductus arteriosus does not close soon after birth. This is called patent ductus arteriosus, or PDA. Normally, deoxygenated blood carrying the waste product, carbon dioxide, returns from the body to the heart and gets pumped to the lungs, via the pulmonary artery, to be pick up oxygen and release the carbon dioxide. But if the ductus arteriosis is patent, some of the blood leaks through the ductus and goes into the aorta which is the artery that supplies the blood to the rest of the body. The result is that deoxygenated blood goes back into body without ever getting oxygen from the lungs. Depending on how patent the ductus is it can be problematic for the baby. Large PDAs can be life threatening and may require medication, or surgical ligation to close the opening.
How can we treat PDAs? Treatment of PDAs can involve medicine that have side effects which can be harmful to premature infants. Recently, some studies suggest that giving acetaminophen (Tylenol) can be gentler on the babies without harmful side effects.
Purpose
Our hypothesis is that early treatment of a moderate size PDA with acetaminophen (Tylenol) will:
Who to contact if you want more information
The Research Team will be contacting you regarding your interest in this study.
You may also contact the Sharp Mary Birch Neonatal Intensive Care Unit (NICU) at: 858 939-4298, or NICU Research Offices at: 858 939-4112