Effects of therapeutic approach on the neonatal evolution of very low birth weight infants with patent ductus arteriosus

Sadeck, Lílian S. R.; Leone, Cléa Rodrigues; Procianoy, Renato S.; Guinsburg, Ruth; Marba, Sérgio Tadeu Martins; Martinez, Francisco Eulógio; Rugolo, Lígia Maria Suppo de Souza; Moreira, Maria Elisabeth Lopes; Fiori, Renato Machado; Ferrari, Lígia S L; Menezes, Jucille A.; Venzon, Paulyne Stadler; Abdallah, Vânia Q.s.; Duarte, José Luiz Muniz Bandeira; Nunes, Marynea V.; Anchieta, Lêni Márcia; Filho, Navantino Alves

doi:10.1016/j.jped.2014.04.010

Cited by 19 publications

(9 citation statements)

References 17 publications

(11 reference statements)

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“…Studies in baboons support the perspective that surgical ligation may in fact produce detrimental effects on lung development in preterm infants ( 34 ). Infants treated with prostaglandin inhibitors for PDA have lower rates of BPD and mortality than those treated with surgical ligation ( 35 ). It is speculated that the different effects of pharmacological and surgical closure of PDA on the development of BPD may be related to the anti-inflammatory effects of the medications (ibuprofen or indomethacin) used to close the ductus ( 32 ).…”

Section: Discussionmentioning

confidence: 99%

Prediction of Bronchopulmonary Dysplasia in Preterm Infants Using Postnatal Risk Factors

et al. 2020

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Objective: To identify postnatal risk factors for bronchopulmonary dysplasia (BPD) development in preterm infants with gestational age ≤32 weeks. Methods: Seventy-two preterm infants(30 with BPD and 42 non-BPD controls) admitted in the neonatal intensive care unit (NICU) of the Children's Hospital of Soochow University during 2017 were enrolled in this prospective longitudinal study. Perinatal clinical data, a neonatal critical illness score (NCIS), different soluble B7-H3(sB7-H3), and interleukin-18 (IL-18) levels by days after birth were collected. An early predictive model for BPD development was established based on clinical data using multiple logistic regression analysis. And the sensitivity and specificity of the model were assesed by ROC curve. Results: Electrolyte disturbances, hemodynamically significant patent ductus arteriosus (hs-PDA), and the age that infants achieved 120 kcal/kg.d via enteral feeding ≥40 days after birth were found to be associated with the BPD pathogenesis. Serum sB7-H3, IL-18, and NCIS were significantly higher in the BPD group compared to the non-BPD group (p < 0.05). BPD group had significantly lower enteral fluid and caloric intake compared to the non-BPD group at 1, 7, 14, and 28 days after birth. The risk factors were analyzed by multiple logistic regression and a predictive model of a combination of sB7-H3 (day 7), IL-18 (day 14), NCIS, and clinical risk factors was evaluated via ROC curve with an area under the curve (AUC) of 0.960 having sensitivity of 86.7% and a specificity of 97.6%, respectively. Conclusion: The causes of BPD are multifactorial postnatal risk factors. And the combination of sB7-H3 (day 7), IL-18 (day 14), NCIS, and clinical risk factors (electrolyte disturbances, hs-PDA, and the age that infants achieved 120 kcal/kg.d via enteral feeding ≥40 days after birth) might be served as an optimal predictive model for the occurrence of BPD.

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Section: Discussionmentioning

confidence: 99%

Prediction of Bronchopulmonary Dysplasia in Preterm Infants Using Postnatal Risk Factors

et al. 2020

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“…A previous study reported that persistent PDA was significantly associated with increased duration of mechanical ventilation, oxygen treatment and rates of BPD ( 25 ). Sadeck et al ( 26 ) reported that the conservative approach to PDA was associated with high mortality, the surgical approach to the occurrence of BPD at 36 weeks, and pharmacological treatment was protective for the outcome of mortality or BPD at 36 weeks. The present study had similar observations.…”

Section: Discussionmentioning

confidence: 99%

Relevance of clinical features in the prognosis of bronchopulmonary dysplasia in premature infants

Kong

Ren

et al. 2017

Experimental and Therapeutic Medicine

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The aim of this study is to determine the accuracy rate of bronchopulmonary dysplasia (BPD) diagnosis and risk factors of short-term poor prognosis for premature infants. This study analyzed the clinical data of 81 premature infants (<32 weeks gestational age) with BPD, who were on oxygen therapy >28 days, and survived >36 weeks (corrected age). Outcome measures included treatments, conditions on the 28th day after birth, oxygen therapy conditions at the 36th week, occurrence of any serious complications during hospital stay. The major risk factors affecting prognosis were ventilation duration, duration of oxygen therapy, application of steroids, hypothyroidism and severity of BPD (all P<0.05). Interventions for complications (n=53) resulted in ceased inhalation of oxygen in 12 infants, improvement of symptoms in 26 infants, and were ineffective in 15 infants. BPD prognosis can be improved by shortening the duration of invasive ventilation and correcting thyroid function.

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“…[6,11,43,45,47,63]. In the short term, PDA is associated with arterial hypotension, myocardial dysfunction and systemic perfusion [5,8,38], renal functional disturbances [5,19,39], and pulmonary hemorrhage [40,64,65].…”

Section: Respiratory Distress Syndrome and Patent Ductus Arteriosus Imentioning

confidence: 99%

“…In the short term, PDA is associated with decreased blood pressure [5,8], decreased renal function [5], cardiac congestive failure [18,37,38], pulmonary haemorrhage [8,39], apnea and ventilator-dependency [6,38], bronchopulmonary dysplasia (BPD) [5,14,20,21,25,34,41,42], necrotizing enterocolitis (NEC) [8,9,11,19,20,34,39,43,44], intraventricular hemorrhage (IVH) [5,19,20,39,42,45,46], periventricular leukomalacia (PVL) [5], retinopathy of prematurity (ROP), cerebral palsy [24], delayed growth [11], and increased mortality rate [6,34,45,[47][48][49][50].…”

Section: Introductionmentioning

confidence: 99%

Persistent Ductus Arteriosus in Critically Ill Preterm Infants

Ognean

Boantă

Kovacs

et al. 2016

The Journal of Critical Care Medicine

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Introduction: Persistent ductus arteriosus (PDA) is found with increased incidence in preterm infants, significantly affecting neonatal morbidity and mortality rates. Aim: To evaluate the association between the presence of PDA and the severity of clinical condition at birth in critically ill preterm infants, with gestational ages (GA) ≤ 32 weeks and severe respiratory distress. Methods: All preterm infants with GA ≤ 32 weeks admitted to the neonatal intensive care unit (NICU) of the Clinical County Emergency Hospital, Sibiu between 1 January 2010 and 31 December 2015 were included in the study. These were categorized as Group 1 [Preterm infants with PDA; n=154] and Group 2 [Preterm infants without PDA; n=186]. Epidemiological and clinical data were collected in the National Registry for Respiratory Distress Syndrome for all children, and data related to prenatal period, clinical characteristics at birth i.e GA, weight, gender, Apgar scores, and clinical features such as resuscitation at birth, surfactant administration, need and duration of respiratory support, neonatal sepsis, complications associated with prematurity, and death, were analyzed. Results: Group 1 infants had significantly lower GA and birth weights, were more often out born (p=0.049, HR 1.69), and had significantly lower Apgar scores at 1 and 10 minutes (p=0.022, p=0.000). They presented a significantly higher need for surfactant administration (42.9% vs 24.7%, p<0.0001) and respiratory support (96.8% vs 90.3%, HR 3.19, p=0.019 for need of CPAP and 22.1% vs 10.8%, HR 2.35, p=0.004 for mechanical ventilation). Duration of respiratory support was also significantly higher in the Group 1 (7.6%±7.5 vs. 5.1±3.8 days, p<0.0001 for CPAP and 20.1±22.5 vs. 12.0±15.7 days, p<0.0001 for mechanical ventilation). Conclusion:In very preterm infants, PDA may be associated with a critical clinical condition leading to serious complications. The presence of PDA after the seventh day of life was associated with an increased need for respiratory support, both CPAP and mechanical ventilation, increased severity of the respiratory distress syndrome, requiring a longer duration of respiratory support, and increased the hospitalization length. In very preterm infants, PDA presence was also associated with a higher rate of severe complications and death, indicating the need for a careful and proper management of these critical cases in neonatal intensive care units.

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Effects of therapeutic approach on the neonatal evolution of very low birth weight infants with patent ductus arteriosus

Abstract: The conservative approach of PDA was associated to high mortality, the surgical approach to the occurrence of BPD36wks and ROPsur, and the pharmacological treatment was protective for the outcome death/BPD36wks.

Cited by 19 publications

References 17 publications

Prediction of Bronchopulmonary Dysplasia in Preterm Infants Using Postnatal Risk Factors

Prediction of Bronchopulmonary Dysplasia in Preterm Infants Using Postnatal Risk Factors

Relevance of clinical features in the prognosis of bronchopulmonary dysplasia in premature infants

Persistent Ductus Arteriosus in Critically Ill Preterm Infants

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