Objective The aim of this study was to assess the utility of early postnatal platelet indices in the prediction of hemodynamically significant patent ductus arteriosus (hsPDA) and its response to pharmacological treatment in preterm infants.
Study Design The medical records of 971 infants with gestational age < 30 weeks and birth weight < 1,500 g were analyzed retrospectively. Infants with hsPDA comprised the study group and those without hsPDA comprised the control group. Complete blood count results were recorded, and red cell distribution width-to-platelet ratio (RPR) and platelet mass were calculated.
Results A total of 481 infants, 169 in the hsPDA group and 312 in the control group, were included. In terms of platelet indices, the hsPDA group showed significantly lower mean platelet volume (MPV) and platelet mass, whereas RPR was significantly higher (p < 0.05, respectively). Multiple logistic regression analysis showed that RDS (relative ratio [RR]: 2.39; 95% confidence interval [CI]: 1.45–3.93; p < 0.001), MPV < 7.85 (RR: 3.71; 95% CI: 2.29–6.01; p < 0.001), and RPR > 0.070 (RR: 5.33; 95% CI: 3.28–8.65; p < 0.001) were independent risk factors for hsPDA.
Conclusion Low MPV and platelet mass and high RPR in the first hours of life are risk factors for hsPDA and hsPDA refractive to pharmacological treatment with ibuprofen in preterm infants.
Primary cardiac tumors in infancy and childhood are rare and usually benign. Fibroma is the second most common bening cardiac tumor after rhabdomyoma. Surgery is required when fibromas cause ventricular outflow tract obstruction, ventricular dysfunction and life-threatening arrhythmia. This case report describes a 9-year-old asymptomatic male presenting with a giant left ventricular cardiac fibroma who was followed up using conservative treatment.
Objective We investigated the relationship of serum potassium (K+) and ionized calcium (iCa2+) levels with the persistence of ductus arteriosus.
Study Design This retrospective cohort study included infants with birth weight < 1,500 g and gestational age < 32 weeks. Serum K+ and iCa2+ levels at the 1st and 48th hour of life were measured from samples. The difference between the two levels was calculated for both serum K+ (ΔK+) and iCa2+ (ΔCa2+). These values were compared between hemodynamically significant patent ductus arteriosus (hsPDA) and non-hsPDA.
Results Of 1,322 hospitalized preterm nonates, 1,196 were included in the study. Mean serum K+ levels at the 1st and 48th hour were higher and iCa2+ levels at the 1st and 48th hour were lower in hsPDA and non-hsPDA, respectively (p < 0.001). Ionized ΔCa2+ (–0.06 ± 0.13 vs. –0.02 ± 0.12 mmol/L) was higher in hsPDA (p < 0.001).
Conclusion We demonstrated that serum K+ and iCa2+ level might play a role in ductal constriction.
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