The treatment of patent ductus arteriosus in preterm infants. A review and overview of randomized trials

Knight, David B.

doi:10.1053/siny.2000.0036

Cited by 151 publications

(98 citation statements)

References 55 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It could potentially be an important contributor to neonatal morbidity as it is a surrogate of a generalized systemic hypoperfusion state, as it compromises renal and/or gastrointestinal diastolic blood flow. 4,5 In this paper, we discuss the nature and relevance of ductal steal and compromised systemic blood flow in neonates with a HSDA. There are no conflicts of interest or disclosures.…”

Section: Introductionmentioning

confidence: 99%

Spectral Doppler waveforms in systemic arteries and physiological significance of a patent ductus arteriosus

et al. 2010

View full text Add to dashboard Cite

Patent ductus arteriosus in extremely premature babies is associated with major neonatal morbidities, such as necrotizing enterocolitis and intraventricular hemorrhage. This may be attributable, at least in part, to systemic hypoperfusion secondary to ductal steal. A hemodynamically significant ductus arteriosus (HSDA) is known to be associated with altered systemic blood flow and end-organ hypoperfusion. Although descending aorta blood flow profiles may show abnormal diastolic retrograde flow, Doppler studies of blood flow in the systemic arteries may help improve our understanding of the relationship of a HSDA with these morbidities. In this article, we discuss aspects of diastolic blood flow reversal in the systemic arteries in premature infants with a hemodynamically significant duct. Whether these hemodynamic effects are significant enough to form the basis for initiating treatment is still unclear; these should form the basis for prospective studies.

show abstract

Section: Introductionmentioning

confidence: 99%

Spectral Doppler waveforms in systemic arteries and physiological significance of a patent ductus arteriosus

et al. 2010

View full text Add to dashboard Cite

show abstract

“…Several commentators have suggested that this may not be beneficial. [31][32][33] Others report that ductal ligation is associated with worse neurodevelopmental outcomes, 34 more severe retinopathy of prematurity (ROP), 34 and increased rates of BPD. [34][35][36] Uncertainty about current practices prompted this systematic review, with the objective of identifying empirical evidence supporting treatment of persistent PDA in preterm infants.…”

mentioning

confidence: 99%

Treatment of persistent patent ductus arteriosus in preterm infants: time to accept the null hypothesis?

2010

View full text Add to dashboard Cite

“…In many studies, the treatment results (efficacy, complications, period of mechanical ventilation, lung compliance) are analyzed in the aspect of neonatal age at the time of treatment (7,12). In a large group of studies, a comparative analysis of medical treatment with indomethacin or ibuprofen was performed (13).…”

Section: Discussionmentioning

confidence: 99%

Intraoperative Macroscopic Lung Appearance in Premature Infants with Body Weights Less than 1000 G Undergoing Surgical Treatment for PDA

Wieteska¹,

Karolczak²

2007

Polish Journal of Surgery

View full text Add to dashboard Cite

The aim of the study was to assess the relationship between intraoperatively observed macroscopic pathologic findings in the left lung and the chosen clinical factors. The factors analyzed in the study were the following: neonatal gestational age and body weight, the age of the neonate at the time of surgery, the history of intrauterine infection and/or presence of active infection in the neonate, the history of ibuprofen treatment, and intraoperative diameter of the arterial duct. Material and methods. The authors included a group of 126 preterm infants with body weight less than 1000 g undergoing surgical treatment for PDA in the 2 nd Department of Cardiac and General Pediatric Surgery between January 2000 and May 2006 and analyzed the macroscopic intraoperative left lung appearance. The average body weight of the neonates who participated in the study was 765.2 g, with the average gestational age 25.68 Hbd. According to the results of intraoperative macroscopic lung assessment, the neonates were classified into one of the following three groups: 0 -normal lungs or partially stiff lungs with emphysema focuses, 1 -limited macroscopic findings, focuses of limited atelectasis, lung congestion, 2 -severe pathologic findings in the pulmonary tissue, pulmonary hematomas, bleeding pulmonary surface, disseminated atelectasis, liver-like pulmonary tissue. In the study, the statistical analysis of the relationship between pathological pulmonary findings (groups 0, 1, 2) and investigated factors was performed by the comparison of mean values (or median) of the investigated factor in the analyzed groups. The Kruskal-Wallis and the Mann-Whitney tests were used dependent of the analyzed factor. Additionally, for chosen factors (the infection presence and PDA diameter), their relationship with the lung macroscopic appearance was assessed with the use of the Spearman test. Results. The pathological findings in the lungs were observed in the majority of the neonates (54%). The statistical analysis did not show any relationship between the pulmonary disorders and the majority of investigated factors. Conclusions. 1. The authors found that a duct diameter of ³ 4 mm correlates with the development of more severe disorders in the pulmonary tissue. 2. The authors emphasized the good results of surgical treatment of PDA and the lack of death in the perioperative period in that group of patients. Key words: PDA, ELBW, thoracotomy, lungs Patent ductus arteriosus (PDA) is observed in the majority of premature infants with extremely low body weight. The prevalence of PDA is higher with lower gestational age and lower body weight (1, 2). The relationship was demonstrated between the presence of PDA and not only the newborn gestational age but also the coexistence of respiratory distress and the general health condition of the newborn (3, 4). Significant left-to-right shunt through the arterial duct causes lung congestion, which can result in alveolar transudation. It can cause impaired alveolar ventilation, the development of atelectasis...

show abstract

The treatment of patent ductus arteriosus in preterm infants. A review and overview of randomized trials

Cited by 151 publications

References 55 publications

Spectral Doppler waveforms in systemic arteries and physiological significance of a patent ductus arteriosus

Spectral Doppler waveforms in systemic arteries and physiological significance of a patent ductus arteriosus

Treatment of persistent patent ductus arteriosus in preterm infants: time to accept the null hypothesis?

Intraoperative Macroscopic Lung Appearance in Premature Infants with Body Weights Less than 1000 G Undergoing Surgical Treatment for PDA

Contact Info

Product

Resources

About