Effect of persistent patent ductus arteriosus on mortality and morbidity in very low‐birthweight infants

Tauzin, Laurent; Joubert, C.; Noel, A.; Bouissou, Antoine; Moulies, Marie-Eve

doi:10.1111/j.1651-2227.2011.02550.x

Cited by 28 publications

(20 citation statements)

References 30 publications

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“…abdominal distension, oliguria) [14]. In the absence of clear clinical signs, ascertainment of hemodynamic significance was made on the basis of any of the following echocardiographic characteristics: left atrial/aortic root ratio >1.4, mean velocity in the left pulmonary artery >0.6 m/s or diastolic backflow in the abdominal aorta [15]. …”

Section: Methodsmentioning

confidence: 99%

Platelet Counts in the First Seven Days of Life and Patent Ductus Arteriosus in Preterm Very Low-Birth-Weight Infants

et al. 2014

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Background: Decreased platelet number and/or function are related to patent ductus arteriosus (PDA) in mice. Whether this is also the case in human infants remains controversial. Objectives: To investigate the association between platelet count nadir within the first 7 days of life and the rate of hemodynamically significant PDA (HSPDA), as well as the rate of response to the treatment with cyclooxygenase (COX) inhibitors. Methods: This is a retrospective study of a cohort of 194 very low-birth-weight (VLBW) infants (<1,500 g) with gestational age <30 weeks. HSPDA was assessed by echocardiography on day 3 of life. Results: HSPDA was present in 105 infants (54.1%). Of these, 101 were treated with COX inhibitors. The treatment failure rate was 21.8%. Median platelet count nadir and rate of thrombocytopenia - defined as platelet count <150 × 10⁹/l and graded as mild (100 to <150 × 10⁹/l), moderate (50 to <100 × 10⁹/l) or severe (<50 × 10⁹/l) - within the first 2 days of life were not significantly associated with the presence of HSPDA on day 3. Moreover, low platelet counts, either on days 1-2 or 3-7, were not significantly associated with the rate of response to treatment with COX inhibitors. Conclusions: Our data provide further evidence for the lack of association between platelet counts within the first days of life and either spontaneous or pharmacological closure of the ductus arteriosus in VLBW infants.

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Section: Methodsmentioning

confidence: 99%

Platelet Counts in the First Seven Days of Life and Patent Ductus Arteriosus in Preterm Very Low-Birth-Weight Infants

et al. 2014

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“…[6,11,43,45,47,63]. In the short term, PDA is associated with arterial hypotension, myocardial dysfunction and systemic perfusion [5,8,38], renal functional disturbances [5,19,39], and pulmonary hemorrhage [40,64,65].…”

Section: Respiratory Distress Syndrome and Patent Ductus Arteriosus Imentioning

confidence: 99%

Persistent Ductus Arteriosus in Critically Ill Preterm Infants

Ognean

Boantă

Kovacs

et al. 2016

The Journal of Critical Care Medicine

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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.

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“…Sellmer et al encontraron asociación entre DAP y BDP pero sólo en neonatos nacidos antes de las 28 semanas de EG. La sobrecarga pulmonar puede producir edema pulmonar, mayor necesidad de soporte ventilatorio, mal desarrollo de la (8,33,35,36) estructura alveolar y, en última instancia, BPD .…”

Section: Discussionunclassified

“…Estudios anteriores realizados por Noori et al encontraron una tasa de mortalidad ajustada por factores perinatales de 8 veces más en los pacientes en quienes falló el cierre farmacológico del ductus que en aquellos con ductus cerrado, constituyendo la falla multiorgánica la principal causa de muerte; y Tauzin et al encontraron que la mortalidad por (35,37) riesgo era independiente a similar EG .…”

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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Effect of persistent patent ductus arteriosus on mortality and morbidity in very low‐birthweight infants

Abstract: This study adds further evidence that persistent patent ductus arteriosus has no significant effect on mortality and morbidity in VLBW infants born at ≥25 weeks' gestational age.

Cited by 28 publications

References 30 publications

Platelet Counts in the First Seven Days of Life and Patent Ductus Arteriosus in Preterm Very Low-Birth-Weight Infants

Platelet Counts in the First Seven Days of Life and Patent Ductus Arteriosus in Preterm Very Low-Birth-Weight Infants

Persistent Ductus Arteriosus in Critically Ill Preterm Infants

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

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