Antepartum history of placenta previa, BBW and SBP control may be important for BBW≥1500 g. Surfactant use, dopamine administration and the first 24-hour IVF management may be critical for PDA closure in VLBW neonates. Neonatal care for PDA in prematurity should be meticulously personalized. For neonates with BBW ≥1500 g, placenta previa and lower BBW and systolic blood pressure (SBP) predicted the risk of treatment for PDA and its treatment response. Meanwhile, the cut-off values of the IVF amount (87 and 89.5 ml/kg/day, respectively) might predict the PDA treatment necessity and surgical ligation. For very low birth body weight (VLBW) neonates, surfactant use not only predicted the requirement of PDA treatment, but together with dopamine use and the larger amount of first 24-hour intravenous fluid (IVF) per kilogram of BBW, it also predicted the possibility of surgical ligation. Inclusively, 16.7% of (P)DAs underwent medical and/or surgical treatment. This study involved 682 preterm infants with median gestational age of 31 (interquartile, IQR: 28–34) weeks and BBW of 1360 (IQR: 1085–1861) g. Multivariate analysis was performed using multinomial logistic regression to determine the independent risk factors for the PDA closure. Univariate analysis was performed using non-parametric analysis and Chi-square test or Fisher's exact test. Data relating to birth histories, maternal histories, and clinical data from the first 24 h of life were analyzed according to three types of PDA closure-non-treated, medically-responsive, and surgically-ligated PDA and birth body weights (BBWs). To predict the PDA closure early, we aimed to clarify the association of PDA closure with the initial postnatal 24-hour clinical characteristics and maternal and gestational histories of preterm neonates.Ī retrospective cohort study was conducted in a pediatric-neonatal-intensive-care-unit from 2008 to 2013. Thinking back on this experience, I realize that I should have worn gloves before applying pressure in the wound.Patent ductus arteriosus (PDA) remains a critical issue in prematurity care. Next, we notified the physician immediately about the situation and he rushed to see her. While in the room, we took her vital signs and continued to monitor her vitals every 15 minutes for the first hour. While all this was happening a forth nurse brought a stretcher in which we transferred the patient back to her room. Another nurse cut the girls underwear to have better access to the incision site and to apply the sterile gauze directly over the bleeding site. One of the nurses helped her down to the floor as I applied pressure at the site without wearing any gloves. At the puncture site the patient had a 2×2 gauze dressing with Tegaderm and wrapped with …show more content…įive minutes into her walk, we heard screaming coming from down the hall, several nurses and I ran over and found the girl bleeding profusely from the incision site.
The report I received from the nurse at the Post Anesthesia Care Unit indicated that the patient underwent a cardiac catheterization with access through the right femoral vein and artery. This patient had a history of Patent Ductus Arteriosus, a heart condition in which the ductus arteriosus vessel fails to close after birth compromising the blood circulation by mixing oxygenated blood with the deoxygenated one (Tetsuya, et al., 2015). This little girl had come back from a cardiac catheterization at 12 pm on March 29, 2016. It was around 7 o’ clock in the afternoon on a Tuesday afternoon when my 7 year old patient almost bled out in a hallway at Nicklaus Children’s Hospital.