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Review
. 2023 Sep 1;10(9):377.
doi: 10.3390/jcdd10090377.

Transport and Anaesthesia Consideration for Transcatheter Patent Ductus Arteriosus Closure in Premature Infants

Tuan Chen Aw  1 , Belinda Chan  2   3 , Yogen Singh  4   5
Affiliations
Review

Transport and Anaesthesia Consideration for Transcatheter Patent Ductus Arteriosus Closure in Premature Infants

Tuan Chen Aw et al. J Cardiovasc Dev Dis. .

Abstract

Transcatheter device closure of patent ductus arteriosus (PDA) in preterm infants has been proven to be a feasible and safe technique with promising results when compared to surgical ligation. However, managing transport and anaesthesia in extremely premature infants with haemodynamically significant PDA and limited reserves presents unique challenges. This review article focuses on the key considerations throughout the clinical pathway for the PDA device closure, including referral hospital consultation, patient selection, intra- and inter-hospital transport, and anaesthesia management. The key elements encompass comprehensive patient assessment, meticulous airway management, optimised ventilation strategies, precise thermoregulation, patient-tailored sedation protocols, vigilant haemodynamic monitoring, and safe transport measures throughout the pre-operative, intra-operative, and post-operative phases. A multidisciplinary approach enhances the chances of procedure success, improves patient outcomes, and minimises the risk of complications.

Keywords: anaesthesia; closure; devices; patent ductus arteriosus; premature babies; surgery; transcatheter; transcatheter PDA closure (TCPC); transport.

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Conflict of interest statement

Belinda Chan has received consultant honoraria from the company GE, and 123 sonography. The other authors declare no financial interest.

Figures

Figure 1
Figure 1
Royal Brompton Hospital PDA referral form.
Figure 2
Figure 2
Hamilton-T1 transport ventilator with customized adaptions.
Figure 3
Figure 3
Medirail mount designed for Hamilton ventilator stand (1).
Figure 4
Figure 4
Medirail mount designed for Hamilton ventilator stand (2).
Figure 5
Figure 5
Hamilton transport ventilator in catheter lab position.
Figure 6
Figure 6
Premature Neonate Airway Pack checklist.
Figure 7
Figure 7
Flow diagram of the transport and anaesthesia process.
See this image and copyright information in PMC

References

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