Patent ductus arteriosus in the preterm infant: to treat or not to treat?

Noori, Shahab

doi:10.1038/jp.2010.97

Cited by 99 publications

(85 citation statements)

References 65 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…As in other studies the current data showed a significant association between PDA and BPD (p=0.002) (Table 4) [6,9,15,20,21,25,41,42,47,[66][67][68][69]. An almost similar risk was reported by Marshall et al in VLBW infants (BW <1500 g) [69].…”

Section: Respiratory Distress Syndrome and Patent Ductus Arteriosus Isupporting

confidence: 75%

“…A significant PDA also affects the cerebral blood flow, mostly during diastole, a possible pathway for IVH and PVL [42,46]. A link between PDA and IVH has been reported in many studies, as in the current report where there was an increased risk for IVH in Group 1 compared to Group 2 [20,40,46,47,68] (Table 4).…”

Section: Patent Ductus Arteriosus Intraventricular Hemorrhage and Pesupporting

confidence: 64%

“…An almost similar risk was reported by Marshall et al in VLBW infants (BW <1500 g) [69]. In preterm infants with RDS, PDA induces an interstitial and alveolar pulmonary edema, decreases pulmonary compliance, increases the need and length of mechanical ventilation and oxygen needs, thus increasing the risk for BPD [5,42].…”

Section: Respiratory Distress Syndrome and Patent Ductus Arteriosus Isupporting

confidence: 53%

“…The current study also showed an increased incidence of NEC in preterm infants ≤ 32 weeks gestation, but the low number of NEC cases may explain the lack of significance of this association (Table 4). Predisposition to NEC in preterm infants with PDA is due to diastolic blood stealing from the superior mesenteric artery and abdominal aorta through DA with secondary intestinal hypoperfusion [5,42,43].…”

Section: Patent Ductus Arteriosus and Necrotizing Enterocolitis In Vementioning

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%

See 4 more Smart Citations

Persistent Ductus Arteriosus in Critically Ill Preterm Infants

Ognean

Boantă

Kovacs

et al. 2016

The Journal of Critical Care Medicine

View full text Add to dashboard Cite

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.

show abstract

Section: Respiratory Distress Syndrome and Patent Ductus Arteriosus Isupporting

confidence: 75%

Section: Patent Ductus Arteriosus Intraventricular Hemorrhage and Pesupporting

confidence: 64%

Section: Respiratory Distress Syndrome and Patent Ductus Arteriosus Isupporting

confidence: 53%

Section: Patent Ductus Arteriosus and Necrotizing Enterocolitis In Vementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Persistent Ductus Arteriosus in Critically Ill Preterm Infants

Ognean

Boantă

Kovacs

et al. 2016

The Journal of Critical Care Medicine

View full text Add to dashboard Cite

show abstract

Outcomes of Primary Ligation of Patent Ductus Arteriosus Compared With Secondary Ligation After Pharmacologic Failure in Very-Low-Birth-Weight Infants

et al. 2013

View full text Add to dashboard Cite

This study aimed to determine whether primary surgical closure of patent ductus arteriosus (PDA) is a risk factor for morbidity and mortality compared with secondary surgical ligation. The study enrolled 178 very-low-birth-weight infants. The surgical group included 34 patients who did not respond to pharmacologic intervention and eventually required ligation of their PDA as well as 35 patients who underwent direct ligation because of contraindications to the use of oral ibuprofen. The overall outcomes for the primary and secondary ligation groups were compared. The outcome during hospitalization showed no statistically significant difference in terms of morbidity and mortality between the two groups. The group that had primary ligation for PDA experienced more complications associated with premature birth such as lower gestational age and birth weight. The two groups did not differ significantly in terms of overall outcomes.

show abstract

Surgical Ligation Versus Percutaneous Closure of Patent Ductus Arteriosus in Very Low-Weight Preterm Infants: Which are the Real Benefits of the Percutaneous Approach?

et al. 2017

View full text Add to dashboard Cite

Percutaneous treatment of patent ductus arteriosus (PDA) in extreme premature infants is technically difficult, and therefore, often not consider as an alternative to surgery. The main objective of our work was to compare respiratory status prior and post ductal closure and morbi-mortality, in our series of preterm infants with percutaneous PDA closure versus surgical ligation in the same time-period. Retrospective review of all premature infants submitted to percutaneous and surgical PDA closure from January 2011 to December 2016. All the antenatal, perinatal, and postnatal characteristics were collected. The main outcome was the assessment of the pulmonary status before and after ductal closure using a pulmonary score. Secondary outcomes included moderate-severe disability in neurodevelopment, death before discharge, moderate-severe chronic lung disease, and morbidity at discharge. 25 patients with a mean weight of 1330 g (± 280) underwent percutaneous closure of PDA with ADO-II-AS, and a total of 53 underwent surgical ligation. 28/53 with similar gestational age, birth weight, and procedure weight to those in the percutaneous group, were selected to perform the comparative study. Ductal closure (percutaneous and surgical) resulted in improved respiratory status. However, percutaneous group achieved a fastest respiratory improvement, than surgical group. The surgical closure group associated higher morbidity among survivors (HIV, number of sepsis, need, and duration of inotropics post-interventionism). The incidence of recurrent laryngeal nerve palsy among the surgical group was 17%. Percutaneous closure of PDA in carefully selected low-weight preterm infants is a safe and reliable alternative to surgical ligation.

show abstract

Patent ductus arteriosus in the preterm infant: to treat or not to treat?

Cited by 99 publications

References 65 publications

Persistent Ductus Arteriosus in Critically Ill Preterm Infants

Persistent Ductus Arteriosus in Critically Ill Preterm Infants

Outcomes of Primary Ligation of Patent Ductus Arteriosus Compared With Secondary Ligation After Pharmacologic Failure in Very-Low-Birth-Weight Infants

Surgical Ligation Versus Percutaneous Closure of Patent Ductus Arteriosus in Very Low-Weight Preterm Infants: Which are the Real Benefits of the Percutaneous Approach?

Contact Info

Product

Resources

About