دور سلفات المغنيزيوم في معالجة فرط التوتر الرئوي المستمر عند حديثي الولادة
Abstract
فرط التوتر الرئوي المستمر عند حديثي الولادة (PPHN ) هو حالة حرجة ناجمة عن الفشل في عملية التأقلم القلبي- الرئوي الطبيعي بعد الولادة ، هناك عدد من العوامل التي يمكن أن تتدخل في هذه العملية مثل مرض البارانشيم الرئوي ، تناذر استنشاق العقي ، نقص الأكسجة المزمن داخل الرحم ، نقص الأكسجة حول الولادة، انتان الدم،سوء تطور الرئة.
أجرينا في شعبة العناية بالخديج والوليد في مشفى الأسد الجامعي باللاذقية دراسة سريرية لتحديد مدى فعالية سلفات المغنيزيوم في معالجة فرط التوتر الرئوي المستمر عند حديثي الولادة ، حيث قمنا بدراسة سبعة ولدان قبلوا في الشعبة المذكورة بحالة فرط توتر رئوي مستمر . بدأنا بجرعة من سلفات المغنيزيوم 200 ملغ /كلغ خلال 60 دقيقة ، تليت بجرعة داعمة 20 ملغ /كلغ/ساعة . لاحظنا ارتفاعاً ذو اهمية احصائية في متوسط تركيز PaO2 وأيضاً تحسناً مهماً في متوسط المشعر السنخي – الشرياني ( A-aDO2) بعد 24 ساعة من البدء بتسريب سلفات المغنيزيوم بينت هذه الدراسة أن سلفات المغنيزيوم هي موسع وعائي رئوي فعال وآمن ويمكن استخدامها كخط أول في معالجة فرط التوتر الرئوي المستمر عند حديثي الولادة.
Persistent Pulmonary Hypertension in Newborn babies (PPHN) is a neonatal severe case due to the failure of normal cardiopulmonary adaptation following delivery. A variety of events may interfere with this process such as Parenchyma lung disease, me conium aspiration, intrauterine and/or prenatal hypoxia, sepsis, and abnormal pulmonary development. A clinical study to assess the efficiency of magnesium sulfate in the treatment of PPHN was conducted in the neonatal care unit of Al-Assad University Hospital in Lattakia. Seven newborn babies admitted consecutively to the neonatal care unit with persistent pulmonary hypertension were included in this study. A loading dose of 200 mg/kg/ magnesium sulfate was given over a period of 60 minutes, followed by a continuous infusion of 20 mg/kg/hour. Mean values of PaO2 significantly increased after 24 hours; mean alveolar–arterial oxygen gradient (A- aDO2) was significantly lowered after 24 hours. In this study, magnesium sulfate was found to be a safe and effective pulmonary vasodilatator. Magnesium sulfate could be used as the first resort vasodilatator for treating PPHN.
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