Entry For December 26,2005

Entry for December 26, 2005
PATENT DUCTUS ARTERIOSUS (PDA)The ductus arteriosus is a normal fetal structure, allowing blood to bypass circulation to the lungs. Since the fetus does not use his/her lungs (oxygen is provided through the mother’s placenta), flow from the right ventricle needs an outlet. The ductus provides this, shunting flow from the left pulmonary artery to the aorta just beyond the origin of the artery to the left subclavian artery. The high levels of oxygen which it is exposed to after birth causes it to close in most cases within 24 hours. When it doesn’t close, it is termed a Patent Ductus Arteriosus.The defect often corrects itself within several months of birth, but may require infusion of chemicals, the placement of "plugs" via catheters, or surgical closure.The flow pattern is similar to the septal defects noted above, except that the shunting occurs outside of the heart. The left ventricle has to pump blood out through the aorta, only to have some of it flow to the lower pressure pulmonary artery, and directly back to the left atrium and ventricle. If a large PDA is not corrected, then the pressures in the pulmonary arteries may become very high and induce changes in the arteries themselves such that even closure of the defect will no longer improve the patient. In this case, the pressures in the right side of the heart are high enough that blood may begin to flow from the right to the left side of the heart. This situation is called "Eisenmenger’s syndrome", a condition which may result from several similar abnormalites.©COPY;1997 HeartPoint Updated November 1997PATENT DUCTUS ARTERIOSUS (PDA)What is the ductus arteriosus?The ductus arteriosus is a wide muscular blood vessel joining the pulmonary artery (main artery to the lungs) to the aorta (main artery to the body). This connection allows blood to be diverted from the lungs into the aorta during fetal development since the baby does not breathe until after delivery. The ductus arteriosus normally closes after birth. If it fails to close, PDA (patent or open ductus arteriosus) occurs and blood continues to flow from the aorta to the pulmonary artery. The effects of this altered circulation are : * increased work of breathing * increased workload on the heart* fluid in the lung* right heart enlargement* increased lung workloadDiagram of the normal heart: blood flows from the left ventricle, into the aorta, and then out to the rest of the body. Diagram of a heart with a PDA (patent ductus arteriosus): blood flows from the left ventricle, into the aorta, and then into the pulmonary artery (instead of going to the body where it is needed).How is a PDA (patent ductus arteriosus) treated?In small or premature babies, medicine may be used first to try to close the ductus arteriosus. In some cases medicine does not work or cannot be used and the ductus arteriosus must be closed surgically. Surgical correction includes closure of the PDA through a left thoracotomy incision (left underarm). The ductus is closed with a clip or is tied shut. In older children, medical treatment does not work. The ductus can be closed surgically or, in some children, a device placed through the artery into the ductus can be used. Just a little information about PDA-Caitlin could possibly have this her little valve did open a little bit so they are going to keep a close eye on it and see if it will close up by itself. Today she is 26 weeks gestation almost 2 weeks old. She has been doing pretty good, still ppretty stable, they had to up her oxigen a little bit yesterday and will start to wean her down a bit. Called last night and she was a wild women again so they had to give her some relax meds to sedate her and calm her down,She is getting a PIC line today, it is a small IV line that goes from her arm all the way up her arm close to her heart and it is for all of her IV's so they do not have to keep poking her , she is getting one of her lines out from her tummy because it is getting loose so that is also the reason for the PIC line. I hate this I wish she could just be in me so she wouldn't have to get poked at and pronged and this and that. It makes me so sad because I am still suppose to be pregnant with both my girls and I feel so empty without them and so scared for Caitlin because you never know what the next 5 mins is going to bring. She is so cute already and such a fighter I can not imagine myself without her now. We brought all of her little gifts yesterday for Christmas and we met our neigbors finally lol. They are such nice people, their names are Jerry and Brittney and their little baby's name is Katie , she is a cutie,she is about 35 weeks I think, she had lost alot of blood from her birth and they pulled her out to early because they were a month off on her due date.Well I will update later on today about how Caitlin did for her PIC line. It is kind of like a minnie surgery , she has to have X-rays so they make sure they place it right and all that yuccky stuff. They have to numb her also. I just hope she does ok and stays infection free because that could happen as well, Gosh I can't believe I am still ahving to worry about infections, I had to worry about them while I was pregnant because that was the biggest worry and also now worry about then for My little princess. Thank goodness for antbiotics but still not always a guarentee. ughhhhhhh.Ok will write later for Caitlins update today.