Guideline management of PDA

Guideline management of PDA

Hemodynamic significant PDA
BounHdeinmgopduylnsaemic significant PDA
BWoiduendpinuglsepuplrseessure (>25mmHg)
WSigidnespouflpseulpmroensasuryreed(>e2m5ammHg)
RHeesppaitroamtoerygadliystress, desaturation
HInecpreaatosmedegvaelnytilator settings

Consider consult cardiologist for Surgical
confirmation treatment

Conservative Medical failed
treatment treatment
failed

-restrict fluid ทารกมขี ้อห้ามของการให้ NSAIDs?
-diuretics: furosemide
Urine<0.6ml/kg/hr, Cr ≥1.8 mg/dl, BUN ≥30mg/dl, platelet <50,000, GI bleeding, NEC, IVH ใน 7
Yes
วนั No No
Acetaminophen
Dose: Ibuprofen Indomethacin
15 mg/kg/dose po q 6 hrs x 3d Dose:
Drug monitoring: Standard dose(total 3 doses): Age at 1st 2nd 3dr
Lab: AST, ALT 10mkdose – 5mkdose – 5mkdose??
10mkdose – 10mkdose – 10mkdose? 1st dose 0.1
หา่ งกนั 12-24 hr 0.2
Drug monitoring: <48 hr 0.2 0.1 0.25
Lab: BUN, Cr
Urine output, feeding 2-7d 0.2 0.2

>7d 0.2 0.25

แตล่ ะdoseหา่ งกนั 12-24 hr

Drug monitoring:

Lab: BUN, Cr

Urine output, feeding, NEC, GI bleeding

Gillam-Krakauer et al, Neoreview 2018;19;e394
Mitra et al, JAMA 2018, vol 319: 12
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