Lower early postnatal oxygen saturation target and risk of ductus arteriosus closure failure

Inomata, Kei; Taniguchi, S.; H, Yonemoto; Inoue, Takeshi; Kawase, Akihiko; Kondo, Yuichi

doi:10.1111/ped.12987

Cited by 5 publications

(2 citation statements)

References 28 publications

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“…Reported data came from 37 publications from Europe (23 distinct data sources) [13,18,, 38 publications from North America (19 data sources) [3,, 19 from Asia (16 data sources) [94][95][96][97][98][99][100][101][102][103][104][105][106][107][108][109][110][111][112], and six from Oceania (Australia and New Zealand; six data sources) [113][114][115][116][117][118]. Additionally, two publications included data from both Europe and North America [119,120], and one publication included stratified data from both Asia and North America [121].…”

Section: Literature Search Resultsmentioning

confidence: 99%

Global incidence of bronchopulmonary dysplasia among extremely preterm infants: a systematic literature review

Siffel

Kistler

Lewis

et al. 2019

The Journal of Maternal-Fetal & Neonatal Medicine

156

110

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Background: Infants born extremely preterm (<28 weeks gestational age (GA)) face a high risk of neonatal mortality. Bronchopulmonary dysplasia (BPD) is the most common morbidity of prematurity. Objective: To evaluate the global incidence of BPD among infants born extremely preterm. Design: A systematic review of the literature was conducted in Embase and MEDLINE (via PubMed) using a prespecified search strategy for BPD and prematurity. Observational studies published in English between 16 May 2006 and 16 October 2017 reporting on the occurrence of BPD in infants born <28 weeks GA were included. Results: Literature searches yielded 103 eligible studies encompassing 37 publications from Europe, 38 publications from North America, two publications from Europe and North America, 19 publications from Asia, one publication from Asia and North America, six publications from Oceania, and zero publications from Africa or South America. The reported global incidence range of BPD was 10-89% (10-73% in Europe, 18-89% in North America, 18-82% in Asia, and 30-62% in Oceania). When only population-based observational studies that defined BPD as requiring supplemental oxygen at 36 weeks postmenstrual age were included, the global incidence range of BPD was 17-75%. The wide range of incidences reflected interstudy differences in GA (which was inversely related to BPD incidence), birthweight, and survival rates across populations and institutions. Conclusions: BPD is a common health morbidity occurring with extremely preterm birth. Further study of factors that impact incidence, aside from low GA, may help to elucidate modifiable risks.

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Section: Literature Search Resultsmentioning

confidence: 99%

Global incidence of bronchopulmonary dysplasia among extremely preterm infants: a systematic literature review

Siffel

Kistler

Lewis

et al. 2019

The Journal of Maternal-Fetal & Neonatal Medicine

156

110

View full text Add to dashboard Cite

show abstract

“…Noori et al found the incidence of HSPDA is higher with lower O2 saturation limits 34 , and Inomata et al determined that a lower oxygen saturation target range in the rst 72 h of life was an independent risk factor for PDA closure failure 35 , consistent with our observation that infants with a higher PO2 were more likely to close spontaneously; arterial PO2 and O2 saturation follow a similar curve [or are directly proportional/or positively correlated] [Collins 2015]. Similarly, Steiner et al found infants with PDA who ultimately required ligation had signi cantly lower oxygen saturation in the rst 5 days of life 30 .…”

Section: Discussionmentioning

confidence: 99%

Factors Predicting Spontaneous Closure of Patent Ductus Arteriosus in Very Low Birth Weight Neonates

Depala,

Atkinson,

Budhani

et al. 2023

Preprint

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Background: Management of hemodynamically significant patent ductus arteriosus (hsPDA) in very low birth weight (VLBW) neonates remains a challenge. Accurate prediction of spontaneous PDA closure could allow selective medical treatment and prevent unnecessary medical intervention. This study aims to evaluate potential variables as predictors of spontaneous closure of hsPDA in VLBW infants. Methods: We conducted a retrospective review of VLBW infants born from 2006 to 2014 at our institution. Infants included in the study were diagnosed with moderate to large hsPDA on echocardiogram in the first week of life. We divided our population into 2 study groups: PDA closure before discharge without medical/surgical treatment (spontaneous closure) and PDA closure by medical or surgical treatment warranted by critical clinical status. Relevant baseline data and PDA-related parameters were extracted from the medical records. Statistically significant variables were further analyzed using a multiple logistic regression model to identify potential independent predictors of spontaneous closure. Results: 108 infants were included in the study; 52 had spontaneous PDA closure and 56 required treatments. Of the baseline characteristics, only gestational age and mode of delivery differed significantly between infants with spontaneous closure and those who required treatment. Significant variables included hematocrit and fluids received on day 1 of life, pre-diagnosis mean pH, PCO2, serum bicarbonate, average fluid goal, and average urine output. After multiple logistic regression analysis, controlling for statistically significant and clinically relevant variables, Cesarian section (OR, 0.18, 95% CI, 0.06-0.55; P=.003), average pre-diagnosis PCO2 (OR, 0.92; 95% CI, 0.86-0.98; P=0.008) and pre-diagnosis daily fluid received (OR, 0.96; 95% CI, 0.94-0.99; P=0.03) were independent predictors of spontaneous closure. Sensitivity and specificity analysis of predictor variables revealed highest sensitivity cut-off points of 40 mm Hg (71.2%) for PCO2, 104 mL/kg/d (71.2%) for fluid goal and highest specificity cut-offs of 64 mm Hg (91.1%) and 158 mL/kg/d (96%), respectively. Conclusion: In our study of VLBW infants, lower average pre-diagnosis CO2, lower daily fluid goal, and vaginal birth were associated with increased likelihood of spontaneous hsPDA closure.

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Prediction of Therapeutic Response to Cyclooxygenase Inhibitors in Preterm Infants with Patent Ductus Arteriosus

Jin

Jiang

et al. 2018

Pediatr Cardiol

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Patent ductus arteriosus (PDA) is a morbid condition commonly seen in premature infants. Cyclooxygenase (COX) inhibitors, such as indomethacin and ibuprofen, are often used for the treatment of PDA in preterm infants, and they work by reducing the production of prostaglandin. However, as observed in clinical practice, not all PDAs in preterm infants can be closed using COX inhibitors. Some studies have demonstrated that gestational age, birth weight, B-type natriuretic peptide (BNP), and ductal diameter can predict the therapeutic responsiveness to COX inhibitors. This paper reviews the factors that can predict successful closure of the PDA in preterm infants using indomethacin or ibuprofen and presents new opinions and recent findings on this topic, including the predictive roles of intrauterine growth restriction, timing of the treatment, and the importance of platelet count and arterial pH. We also discuss the prospects for future studies to improve the individualized therapy of PDA in premature neonates.

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Lower early postnatal oxygen saturation target and risk of ductus arteriosus closure failure

Abstract: Lower early postnatal oxygen saturation target range increases the risk of DA closure failure.

Cited by 5 publications

References 28 publications

Global incidence of bronchopulmonary dysplasia among extremely preterm infants: a systematic literature review

Global incidence of bronchopulmonary dysplasia among extremely preterm infants: a systematic literature review

Factors Predicting Spontaneous Closure of Patent Ductus Arteriosus in Very Low Birth Weight Neonates

Prediction of Therapeutic Response to Cyclooxygenase Inhibitors in Preterm Infants with Patent Ductus Arteriosus

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