A continuous, machine-like murmur is characteristic of a patent ductus arteriosus (FA2020 p291, p298)
The patency of the ductus arteriosus is maintained by prostaglandins (hence why newborns who need to keep a patent ductus arteriosus due to other heart defects are put on prostaglandin drips).
In this newborn's case, the patent ductus arteriosus is not necessary (there are no signs of additional heart defect that would necessiate it) and thus we want to close it.
To close a PDA, we would want to inhibit prostaglandins somehow, and cyclooxygenase inhibitors (NSAIDs) inhibit the production of prostaglandins and thus would speed up closure of the ductus arteriosus. IV indomethacin or ibuprofen are most commonly used to close the PDA.
Though inhibition of phospholipase A2 by corticosteroids would also serve to inhibit production of prostaglandins, this is more nonspecific and could be associated with more unwanted side effects. Coritcosteroids in a newborn are more often used for neonatal respiratory distress syndrome to elicit production of surfactant.
submitted by โcassdawg(1780)
A continuous, machine-like murmur is characteristic of a patent ductus arteriosus (FA2020 p291, p298)
The patency of the ductus arteriosus is maintained by prostaglandins (hence why newborns who need to keep a patent ductus arteriosus due to other heart defects are put on prostaglandin drips).
In this newborn's case, the patent ductus arteriosus is not necessary (there are no signs of additional heart defect that would necessiate it) and thus we want to close it.
To close a PDA, we would want to inhibit prostaglandins somehow, and cyclooxygenase inhibitors (NSAIDs) inhibit the production of prostaglandins and thus would speed up closure of the ductus arteriosus. IV indomethacin or ibuprofen are most commonly used to close the PDA.
Though inhibition of phospholipase A2 by corticosteroids would also serve to inhibit production of prostaglandins, this is more nonspecific and could be associated with more unwanted side effects. Coritcosteroids in a newborn are more often used for neonatal respiratory distress syndrome to elicit production of surfactant.