3Terapia Intensiva Neonatale
4Terapia Intensiva Cardiopediatrica
5Ostetricia e Ginecologia, Azienda Ospedaliera San Carlo, Potenza;
7Terapia Intensiva Neonatale, Azienda Ospedaliera Di Venere - Giovanni XXIII, Bari;
8Pediatria e Neonatologia, Ospedale di Matera
Key words: Congestive heart failure, Newborn circulation, Congenital heart disease
Congestive heart failure (CHF) is a clinical syndrome in which the heart is unable to pump enough blood to the body to meet its needs, to dispose of venous return adequately, or a combination of the two. CHF in the newborn usually result from congenital heart disease with volume and/or pressure overload; less frequently from primary miocardial disease or disorders of cardiac rhythm. The clinical presentation is characterized by failure to feed and grow, tachycardia, tachypnea/dyspnea, and enlarged liver. The maintenance of the patency of the ductus arteriosus (DA) or the induction of its closure by the administration of, respectively, prostaglandin or indometacin or ibuprofen represents the milestone for the management of critically ill neonates. In most cases prompt interventional cardiac catheterization or surgery is needed. Persistence of the fetal circulation and transient myocardial ischemia are self-limited within a few weeks and require suitable therapy. The Authors report their large multidisciplinary experience (catheter interventions, heart surgery and intensive care) in dealing with such conditions in the neonatal period.
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