Fluid restriction in management of patent ductus arteriosus in Italy: a nationwide survey

Francescato, Gaia; Capolupo, Irma; Cerbo, Rosa Maria; Doni, Daniela; Ficial, Benjamim; Fiocchi, Stefano; Matina, Federico; Milani, Gregorio P.; Mizzoni, Fabio; Salvadori, Severo; Savoia, Marilena; Corsini, Iuri

doi:10.1007/s00431-022-04685-4

Cited by 8 publications

(3 citation statements)

References 41 publications

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“…For premature infants undergoing conservative treatment for patent ductus arteriosus (PDA), water restriction is a commonly used method (27)(28)(29)(30)(31). However, there is no consensus on the amount of water needed to maintain the infant's nutrition and needs while also treating PDA.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, there are significant variations in PDA management among different countries, regions, and hospitals (5,16,(23)(24)(25)(26). Conservative treatment, such as fluid restriction, is one way to manage PDA (27)(28)(29)(30)(31), but evaluating fluid status in premature infants is challenging, and fluid management strategies and incubator humidity settings vary among hospitals.…”

Section: Introductionmentioning

confidence: 99%

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Contemporary fluid management, humidity, and patent ductus arteriosus management strategy for premature infants among 336 hospitals in Asia

Hsieh,

Jeng,

Lin

et al. 2024

Front. Pediatr.

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ObjectivesThe management of patent ductus arteriosus (PDA) is a critical concern in premature infants, and different hospitals may have varying treatment policies, fluid management strategies, and incubator humidity. The Asian Neonatal Network Collaboration (AsianNeo) collected data on prematurity care details from hospitals across Asian countries. The aim of this study was to provide a survey of the current practices in the management of PDA in premature infants in Asian countries.MethodsAsianNeo performed a cross-sectional international questionnaire survey in 2022 to assess the human and physical resources of hospitals and clinical management of very preterm infants. The survey covered various aspects of hospitals resources and clinical management, and data were collected from 337 hospitals across Asia. The data collected were used to compare hospitals resources and clinical management of preterm infants between areas and economic status.ResultsThe policy of PDA management for preterm infants varied across Asian countries in AsianNeo. Hospitals in Northeast Asia were more likely to perform PDA ligation (p < 0.001) than hospitals in Southeast Asia. Hospitals in Northeast Asia had stricter fluid restrictions in the first 24 h after birth for infants born at <29 weeks gestation (p < 0.001) and on day 14 after birth for infants born at <29 weeks gestation (p < 0.001) compared to hospitals in Southeast Asia. Hospitals in Northeast Asia also had a more humidified environment for infants born between 24 weeks gestation and 25 weeks gestation in the first 72 h after birth (p < 0.001). A logistic regression model predicted that hospitals were more likely to perform PDA ligation for PDA when the hospitals had a stricter fluid planning on day 14 after birth [Odds ratio (OR) of 1.70, p = 0.048], more incubator humidity settings (<80% vs. 80%–89%, OR of 3.35, p = 0.012 and <80% vs. 90%–100%, OR of 5.31, p < 0.001).ConclusionsIn advanced economies and Northeast Asia, neonatologists tend to adopt a more conservative approach towards fluid management, maintain higher incubator humidity settings and inclined to perform surgical ligation for PDA.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Contemporary fluid management, humidity, and patent ductus arteriosus management strategy for premature infants among 336 hospitals in Asia

Hsieh,

Jeng,

Lin

et al. 2024

Front. Pediatr.

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“…It is driven by concerns over unnecessary and potentially harmful interventions, without demonstrated benefits other than ductal closure itself [ 7 ]. This approach includes a variety of actions, including positive pressure for respiratory support, mild fluid restriction [ 9 ], selective diuretic use, avoiding anemia and providing adequate nutrition until the duct is no longer hemodynamically significant.…”

Section: Introductionmentioning

confidence: 99%

Transcatheter closure in preterm infants with patent ductus arteriosus: feasibility, results, hemodynamic monitoring and future prospectives

Francescato,

Doni,

Annoni

et al. 2023

Ital J Pediatr

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Ductal patency of preterm infants is potentially associated with long term morbidities related to either pulmonary overflow or systemic steal. When an interventional closure is needed, it can be achieved with either surgical ligation or a catheter-based approach.Transcatheter PDA closure is among the safest of interventional cardiac procedures and it is the first choice for ductal closure in adults, children, and infants weighing more than 6 kg. In preterm and very low birth weight infants, it is increasingly becoming a valid and safe alternative to ligation, especially for the high success rate and the minor invasiveness and side effects. Nevertheless, being it performed at increasingly lower weights and gestational ages, hemodynamic complications are possible events to be foreseen.Procedural steps, timing, results, possible complications and available monitoring systems, as well as future outlooks are here discussed.

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Fluid restriction for treatment of symptomatic patent ductus arteriosus in preterm infants

MacLellan,

Cameron-Nola,

Cooper

et al. 2024

Cochrane Database of Systematic Reviews

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Fluid restriction in management of patent ductus arteriosus in Italy: a nationwide survey

Cited by 8 publications

References 41 publications

Contemporary fluid management, humidity, and patent ductus arteriosus management strategy for premature infants among 336 hospitals in Asia

Contemporary fluid management, humidity, and patent ductus arteriosus management strategy for premature infants among 336 hospitals in Asia

Transcatheter closure in preterm infants with patent ductus arteriosus: feasibility, results, hemodynamic monitoring and future prospectives

Fluid restriction for treatment of symptomatic patent ductus arteriosus in preterm infants

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