Multiscale Modeling Is Required for the Patent Ductus Arteriosus in Preterm Infants

Frontiers in Pediatrics

article

Harvey Ho¹  Xiaojuan Ji² 

[1] Auckland Bioengineering Institute, The University of Auckland;Department of Ultrasound, Chongqing General Hospital, University of Chinese Academy of Sciences

关键词: ductus arteriosus;    fetus;    neonates;    in silico modeling;    circulation;    hemodynamics;   

DOI  :  10.3389/fped.2022.857434

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

The ductus arteriosus (DA) in the fetus diverts most of the deoxygenated blood returning from the head, upper extremities and coronary sinus into the descending aorta, bypassing the pulmonary circulation (1, 2). The DA in full-term newborns closes within 24 to 48 h after delivery to facilitate the blood perfusion of lung tissues. However, DA often fails to close in preterm neonates. Indeed, 70% of preterm infants delivered before 28 weeks of gestation require surgical closure or pharmaceutical treatment (1). Patent DA (PDA) in preterm infants causes severe left-to-right shunting. The overloaded pulmonary perfusion causes pulmonary edema, bronchopulmonary dysplasia, pulmonary hypertension and other conditions such as hyperactive precordium and cardiomegaly (3, 4). From a hemodynamic perspective, the high resistance in the pulmonary bed and higher pressure in the pulmonary artery drive the blood flow through the DA into systemic circulation during fetal life. After delivery, the pressure gradient between pulmonary and systemic circulations reverses and exposes the pulmonary microvasculature to systemic blood pressure and increased pulmonary blood flow from PDAs (1, 5).

【 授权许可】

CC BY