A 2-day-old male infant born to a diabetic mother presents with cyanosis and severe respiratory distress. Vital signs show HR 168/min, RR 52/min, BP 58/35 mmHg, SpO2 75% on room air, and temperature 37.2°C. Chest X-ray demonstrates an egg-on-string appearance. Echocardiography confirms transposition of the great arteries with an intact ventricular septum. Arterial blood gas shows hypoxemia. There is no murmur on cardiac auscultation. Which of the following is the most appropriate immediate management?
- A)Oxygen therapy and observation
- B)Prostaglandin E1 infusionGABARITO
- C)Urgent surgical ligation of PDA
- D)Indomethacin to promote PDA closure
- E)Balloon atrial septostomy alone
Explicação
In transposition of the great arteries (TGA), survival depends on maintaining patent ductus arteriosus (PDA) and/or foramen ovale to allow mixing of oxygenated and deoxygenated blood. Prostaglandin E1 keeps the ductus arteriosus open, improving systemic oxygen... Ver explicação completa e trilha adaptativa →