Hello everyone, today I am going to talk about a condition called patent ductus arteriosus. Before going into the specifics of this condition, briefly, let’s understand what circulation means. The circulation of blood is essential to provide important nutrients like oxygen and also to take away the products of the metabolism from the tissues like carbon dioxide and eliminate them. For the purpose of this discussion, I am going to simplify the circulation into 3 parts. The important part which is the heart, which acts like a pump and then the body circulation, which includes all the blood vessels and blood supply to the brain and the other organs and then the blood purifier, which is the lungs. The impure blood from the body carrying all the harmful substances will be pumped into the heart, where they get pumped into the lungs for purification. In the lungs, the carbon dioxide gets eliminated when we exhale and the oxygen, which enters involves into the blood. This blood gets pumped back to the heart. The pure blood and the impure blood doesn’t mix there. The pure blood again gets pumped from the heart into the body. This cycle is continuous to ensure that the nutrients are provided and the products of the metabolism get excreted. In the fetal stage, that is prior to the birth in the womb, mother’s circulation helps in purification and elimination of these harmful products. Let us try to understand how that happens. The placenta, which is the connection between the mother’s circulation and the baby’s circulation, pumps out the pure blood into the body. The heart again functions as the pump, pumping the pure blood into the body and the impure blood from the body enters into the heart and gets pumped into the placenta for further purification. Here, the role of the lungs is very minimum. This is the fundamental difference prior to the birth and after birth. To facilitate more blood flow into the body and into the placenta, in the fetal stage ,there is a connection between the circulation to the lungs and circulation back into the body. This is called as ductus. Let us look at the situation after the birth. For simplification, imagine this as the heart, which is the pump. From the heart the impure blood circulates into the lungs, it gets purified, comes back up into the heart. From the heart, this pure blood gets circulated to the body tissues and the products of metabolism come back to the heart. However, soon after the birth, the connection, which I explained earlier, between the lungs circulation and the body circulation remains. This is called ductus and if it remains, it is called as patent ductus arteriosus. What are the problems associated with it? As you could see, if this remains after the birth, the lungs can get flooded with excessive blood, from the body’s circulation. When this excessive blood enters the lungs, the lungs become heavy, causing difficulty in breathing, needing more breathing support in premature infants. Also, because more blood enters into the lungs, less blood enters into the body. This causes low blood pressure and also affects the various other organs of the body like the brain and the kidneys.
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