Duktus Arteriosus pada Bayi Prematur
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Abstract
Abstract—Ductus arteriosus (DA) is a connecting vessel between proximal descending aorta and pulmonary artery. This important structure normally close after birth. The opened ductus causes increasing of pulmonary blood flow and decreasing of certain organ blood flow (intestine, skin, muscle, and renal) causing complications such as heart failure, metabolic acidosis, necrotizing enterocolitis, and pulmonary edema/bleeding. Prevalence of DA is 0,2/1000 live birth. In under 1500 g babies the proportion of DA is 25%. Surgery and medicine are the treatment modalities of DA closure. Modalities of medicine are indometacine, ibuprofen, and paracetamol. These three modalities work by inhibiting cyclooxygenase enzime causing blockade of prostaglandin synthesis. Drug adverse event can be minimized by carefull in making treatment choice.
Keywords: ductus arteriosus, complication, treatment
Abstrak—Duktus arteriosus (DA) merupakan pembuluh darah yang menghubungkan aorta desendens proksimal dan arteri pulmonalis. Struktur yang penting pada janin tersebut secara normal menutup setelah lahir. Duktus yang masih terbuka tersebut mengakibatkan peningkatan aliran darah paru dan penurunan aliran darah ke organ usus, kulit, otot, dan ginjal sehingga menyebabkan komplikasi seperti gagal jantung, asidosis metabolik, necrotizing enterocolitis (NEC), serta edema paru/perdarahan. Prevalensi DA yang masih terbuka adalah 0,2 per 1000 kelahiran hidup. Proporsi bayi yang bergejala dengan DA yang masih terbuka kurang lebih 25% bayi dengan berat badan lahir di bawah 1500g. Pilihan terapi penutupan DA adalah cara bedah dan medis. Cara medis memiliki beberapa pilihan yaitu indometasin, ibuprofen, dan parasetamol. Ketiga modalitas terapi tersebut bekerja melalui penghambatan enzim siklooksigenase sehingga sintesis prostaglandin terhambat. Beberapa hal perlu diperhatikan dalam membuat pilihan terapi sehingga komplikasi yang berhubungan dengan efek samping obat dapat dihindari..
Kata kunci: ductus arteriosus, komplikasi, terapi
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