Incidence and treatment of the patent ductus arteriosus in the ill premature neonate

Zachman, Richard D.; Steinmetz, George P.; Botham, Richard J.; Graven, Stanley N.; Ledbetter, Marion K.

doi:10.1016/0002-8703(74)90413-x

Cited by 48 publications

(7 citation statements)

References 19 publications

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“…Management of persistent ductus arteriosus in preterm infants has been the subject of much research, discussion, and debate (Zachman et al, 1974;Neal et al, 1975;Thibeault et al, 1975). Until recently, if medical management failed, the only alternative was surgical ligation.…”

mentioning

confidence: 99%

Failure of indomethacin to close persistent ductus arteriosus in infants weighing under 1000 grams.

Ivey¹,

Kattwinkel²,

Park³

et al. 1979

Heart

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mentioning

confidence: 99%

Failure of indomethacin to close persistent ductus arteriosus in infants weighing under 1000 grams.

Ivey¹,

Kattwinkel²,

Park³

et al. 1979

Heart

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“…At the time of study, weights ranged from 700-1910 grams with a mean of 1278 grams. Twentyfour infants (two without pulmonary disease) had a large PDA based on clinical criteria.23 24 That is, all had persistent signs of PDA (as described above), and all ultimately required surgical ligation of the PDA for suspected refractory congestive heart failure (i.e., failure to demonstrate improvement of, or progressive deterioration of, pulmonary and/or cardiovascular status for 24-72 hours following institution of therapy for cardiac failure). At the time of study, weights ranged from 620-1800 grams with a mean of 1115 grams.…”

mentioning

confidence: 99%

Left ventricular performance in the critically ill premature infant with patent ductus arteriosus and pulmonary disease.

Baylen¹,

Ra²,

Korfhagen³

et al. 1977

Circulation

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Left cardiac dimensions and an index of left ventricular performance, the percent shortening of the internal diameter (%SID) of the left ventricle, were evaluated in premature infants who were asymptomatic, others with pulmonary disease and others with patent ductus arteriosus (PDA). In contrast to controls, left atrial and/or left ventricular end-diastolic dimensions were increased in all infants with clinical criteria of significant PDA. Postoperative dimensions decreased significantly. Percent SID values for normal premature infants (m=33.5%; SD=3.5%) and those with pulmonary disease alone did not differ significantly. In those with clinical criteria of PDA, who were subsequently found to have echocardiographic evidence of left cardiac enlargement, values for %SID were increased. As expected %SID values for individual patients represented a wider range of left ventricular function and/or afterload than for controls. Upon spontaneous or surgical closure of the PDA, %SID returned to normal. A PDA which is associated with left cardiac enlargement exhibits increased %SID, whereas decreasing %SID in the presence of increased dimensions suggests deteriorating myocardial performance. Echocardiography provides valuable insight into the cardiac status of these infants and may contribute to their medical and/or surgical management.

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“…This accounts for the high incidence of sig nificant PDA in recent years, ranging from 15 to 80% in neonates [Kitterman et al, 1972;Heymann, 1976;Zachman et al, 1974], The occurrence of a significant PDA is inversely related to the maturity of the…”

Section: Introductionmentioning

confidence: 99%

Role of Indomethacin in Ductus Closure: an Update Evaluation

Douidar

Richardson

Snodgrass³

1988

Dev Pharmacol Ther

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Patent ductus arteriosus (PDA) in premature infants is a current challenge to pediatricians. Pharmacological closure of PDA with indomethacin, a prostaglandin synthetase inhibitor is an effective drug therapy, along with usual medical treatment. Administration of indomethacin may decrease mortality and morbidity (e.g. bronchopulmonary dysplasia) among very small premature infants (< 1,000 g). Co-administration of furosemide with indomethacin may lessen the transient renal side effects of indomethacin. The therapeutic efficacy of indomethacin in closure of PDA depends largely on understanding and manipulation of the pharmacokinetic characteristics of the drug in preterm infants. Maintaining a therapeutic level of the drug in plasma is essential to achieve an optimal therapeutic response. Compared to surgical ligation, indomethacin is a noninvasive, less expensive and safer therapy for ductus closure.

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Incidence and treatment of the patent ductus arteriosus in the ill premature neonate

Cited by 48 publications

References 19 publications

Failure of indomethacin to close persistent ductus arteriosus in infants weighing under 1000 grams.

Failure of indomethacin to close persistent ductus arteriosus in infants weighing under 1000 grams.

Left ventricular performance in the critically ill premature infant with patent ductus arteriosus and pulmonary disease.

Role of Indomethacin in Ductus Closure: an Update Evaluation

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