Does patent ductus arteriosus affect feed tolerance in preterm neonates?

Patole, Sanjay; Kumaran, Vazhkudai S.; Travadi, Javeed; Brooks, Janette; Doherty, Dorota

doi:10.1136/adc.2006.093708

Cited by 30 publications

(15 citation statements)

References 13 publications

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“…Esto podría deberse a la cautela en el inicio y en el aumento del aporte enteral por el riesgo de menor perfusión a nivel mesentérico secundario al shunt ductal y a su vez por la administración de ibuprofeno. En un estudio realizado por Pastore, Kumaran, et al en donde evaluaron si el DAP es un factor de riesgo de intolerancia alimentaria se encontró que el intervalo entre el inicio y la llegada de alimentación completa era mayor en lo pacientes con DAP, lo que aumentaba cuando se combinaba (29)(30)(31)(32) sepsis y ductus .…”

Section: Discussionunclassified

Persistent ductus arteriosus and in-hospital morbidities in newborns of very low birth weight

Genes¹,

Rodas²,

Mir³

et al. 2016

Pediatr. (Asunción)

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RESUMEN Introducción:Objetivo: Materiales y Métodos: Resultados:El ductus arterioso persistente (DAP) es el defecto cardiocirculatorio más frecuente en prematuros, está inversamente relacionado con la edad gestacional y el peso al nacimiento; y se asocia a diversas complicaciones.Evaluar la morbilidad asociada a la presencia de ductus arterioso persistente (DAP) en Recién Nacidos de muy bajo peso al nacer (RMBPN). Estudio retrospectivo de casos y controles anidado en una cohorte de RMBPN admitidos en la UCIN, de enero de 2013 a diciembre de 2015. Excluidos RN con malformaciones congénitas, fallecidos en sala de parto, fallecidos el primer día de vida asociados a asfixia perinatal severa y trasladados a otras instituciones. Las características basales fueron: peso, edad gestacional, sexo, control prenatal, hipertensión materna, embarazo múltiple, restricción del crecimiento, corticoide prenatal, ruptura prolongada de membranas, tipo de parto, Apgar. Las morbilidades analizadas fueron: distres respiratorio (SDR), hemorragia pulmonar, enterocolitis necrozante (ECN), hemorragia intraventricular (HIV), sepsis, soporte respiratorio, broncodisplasia pulmonar (DBP), ruptura alveolar, retinopatía del prematuro (ROP), días de internación y muerte. Se consignaron los datos en SSPS 17 y Epi info 7.2, se aplicó la prueba X² o Fischer, t de Student o la prueba de Mann Whitney. Significancia p< 0,05 con intervalo de confianza 95%.Se incluyeron 131 RN, con DAP 62 y sin DAP 69, cuyas características basales fueron similares, salvo el uso de corticoides prenatales para el grupo sin DAP (p 0.035) RR 0,7 (0,5-0,9). Los RN con DAP tuvieron SDR (p 0,0003) RR 1,5 (1,1-1,9), hemorragia pulmonar (p 0,024) RR 8,9 (1,1-69), ventilación mecánica (p ABSTRACT Introduction:

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Section: Discussionunclassified

Persistent ductus arteriosus and in-hospital morbidities in newborns of very low birth weight

Genes¹,

Rodas²,

Mir³

et al. 2016

Pediatr. (Asunción)

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“…The inability to increase postprandial flow, in the presence of a PDA, may increase the risk for intestinal ischemia, feeding intolerance, and NEC (5, 6, 14, 15, 26). Although it is unlikely that a PDA is sufficient to produce the ischemic injury itself, the inability to increase flow following a feeding might render the intestine more vulnerable to other cardiovascular stresses or ischemic insults.…”

Section: Discussionmentioning

confidence: 99%

“…Numerous studies have shown an association between a persistent PDA and feeding intolerance in preterm infants (5, 6). However, the exact role of the PDA, if any, has yet to be defined (7).…”

Section: Introductionmentioning

confidence: 99%

Effects of a Patent Ductus Arteriosus on Postprandial Mesenteric Perfusion in Premature Baboons

McCurnin

Clyman

2008

Pediatrics

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“…Our findings that significant PDA influences full enteral feed in preterm are in accordance with previous reports. 9 Adverse effects of PDA and therapy for it, including ibuprofen, on intestinal perfusion may explain such results.…”

Section: Discussionmentioning

confidence: 99%

Randomized controlled trial of prophylactic rectal stimulation and enemas on stooling patterns in extremely low birth weight infants

et al. 2013

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OBJECTIVE:We hypothesized that rectal stimulation and small volume enemas would accelerate normalization of stooling patterns in extremely low birth weight infants. STUDY DESIGN: In a randomized controlled trial, infants with a gestational age p28 weeks received one of the following: twice daily rectal stimulation and/or enemas until two stools were passed daily, without enemas or stimulation, for three consecutive days. Intervention only occurred when symptoms, abdominal distension and no defecation, occurred in the previous 24 h. Enema administration occurred if abdominal distension persisted without defecation occurring after rectal stimulation. Multivariable linear regression was used to determine the contribution of a patent ductus arteriosus (PDA) on normalization of stooling patterns and feeding tolerance. RESULT: Rectal stimulation and/or small volume enemas did not accelerate the median (quartile range) time normalization of stooling patterns, 13 (11-20) days in control group and 16 (12-25.5) days in intervention group. A higher frequency of PDA occurred in the intervention than the non-intervention group. Infants with a persistent PDA had a longer duration of parenteral nutrition, worse feeding tolerance and more days to achieve normal stooling patterns. In multivariable regression analysis, a PDA, not repeated rectal stimulation and/or enemas, was significantly related to stooling and feeding tolerance. CONCLUSION: Twice daily administration of rectal stimulation and/or enemas did not normalize stooling patterns (fecal frequency). A PDA is an important determinant of acquisition of normal stooling patterns and feeding tolerance of very immature newborns.

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Does patent ductus arteriosus affect feed tolerance in preterm neonates?

Abstract: Patent ductus arteriosus (PDA), especially PDA with sepsis, has been reported as a risk factor for feed intolerance in preterm neonates. In this study, the start to full feeds interval was found to be longest in preterm neonates (

Cited by 30 publications

References 13 publications

Persistent ductus arteriosus and in-hospital morbidities in newborns of very low birth weight

Persistent ductus arteriosus and in-hospital morbidities in newborns of very low birth weight

Effects of a Patent Ductus Arteriosus on Postprandial Mesenteric Perfusion in Premature Baboons

Randomized controlled trial of prophylactic rectal stimulation and enemas on stooling patterns in extremely low birth weight infants

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