Incidence of vocal fold paralysis in infants undergoing ligation of patent ductus arteriosus

Zbar, Ross I. S.; Chen, Achih H.; Behrendt, Douglas M.; Bell, Edward F.; Smith, Richard J.H.

doi:10.1016/0003-4975(95)01152-8

Cited by 147 publications

(155 citation statements)

References 5 publications

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“…Thirty-two studies that satisfied the inclusion criteria were included in the analysis (Fig 1). OCEBM levels of evidence varied from level 3 (9 studies) [9][10][11][14][15][16]20,23,26 to level 4 (23 studies) [6][7][8]12,13,[17][18][19]21,22,24,25,[27][28][29][30][31][32][33][34][35][36][37] ( Table 1). Occurrence of UVFP, type of surgery, patient demographics, and vocal fold assessment are reported in Table 1.…”

Section: Resultsmentioning

confidence: 99%

Unilateral Vocal Fold Paralysis After Congenital Cardiothoracic Surgery: A Meta-analysis

et al. 2014

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BACKGROUND AND OBJECTIVE: There is variation in the literature in regard to the occurrence of unilateral vocal fold paralysis (UVFP) after congenital cardiothoracic surgery. The objective of this study was to identify and appraise the evidence for the occurrence of UVFP after congenital cardiothoracic surgery in a meta-analysis.METHOD: A comprehensive search strategy in Medline, Embase, and the Cochrane Library was conducted, limited to English publications. Two independent reviewers screened studies for eligibility criteria. Of the 162 identified studies, 32 (20%) met the inclusion criteria. Using the Oxford Centre for Evidence-Based Medicine guidelines, 2 reviewers appraised the level of evidence, extracted data, and resolved discrepancies by consensus. Weighted pooled proportion and 95% confidence intervals (CIs) are reported.

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Section: Resultsmentioning

confidence: 99%

Unilateral Vocal Fold Paralysis After Congenital Cardiothoracic Surgery: A Meta-analysis

et al. 2014

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“…Although the procedure is generally considered to be safe, recent reports indicate that procedural complications such as left vocal cord paralysis may be more frequent than previously thought. 50,51 In addition, there are growing concerns about the immediate short-term and possible long-term effects of surgical ligation. The immediate adverse effects of concern include systemic hypotension, myocardial dysfunction and possible respiratory deterioration in the immediate postoperative period.…”

Section: Surgical Closurementioning

confidence: 99%

Patent ductus arteriosus in the preterm infant: to treat or not to treat?

Noori

2010

J Perinatol

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Pharmacological and/or surgical closure of a hemodynamically significant patent ductus arteriosus (PDA) in the very preterm infant has been the standard of care over the past few decades. However, the rationale for closure of PDA has recently been challenged. In this article, the factors that have fueled the controversy of the approach to the management of PDA and the gap in our knowledge are reviewed in detail. In addition, the pros and cons of the different treatment strategies applied in clinical care are evaluated with a focus on discussing the available evidence in the literature.

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“…Although the direct surgical complications of PDA ligation are well appreciated 18,19 , the ability of the immature myocardium to tolerate sudden changes in LV afterload is less well understood. In a preterm baboon model LV contractility deteriorated 6 to 12 h after PDA ligation, which coincided with a temporal rise in measured systemic vascular resistance.…”

Section: Pda Ligation and Myocardial Performancementioning

confidence: 99%

Postoperative cardiorespiratory instability following ligation of the preterm ductus arteriosus is related to early need for intervention

et al. 2008

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Objective: To investigate the effect of postnatal age at patent ductus arteriosus (PDA) ligation on postoperative need for cardiotropic support.Study Design: A significant proportion of premature infants with a hemodynamically significant ductus arteriosus (HSDA) require surgical intervention. The relationship of postnatal maturation to postoperative cardiorespiratory stability is poorly understood. All preterm neonates who underwent PDA ligation between October 2002 and September 2004 were identified and divided according to postnatal age at ductal ligation, into early (p4 weeks, n ¼ 29) and late (>4 weeks, n ¼ 36) groups. Neonatal birth demographics and morbidities, characteristics of the HSDA and reason for ligation were reviewed. Indices of cardiorespiratory stability (for example heart rate, mean arterial pressure) were recorded before and 1, 4, 8, 12 and 24 h following ligation. Details of perioperative cardiovascular interventions (for example crystalloid boluses, cardiotropic agents) were recorded.Result: There were no differences in baseline neonatal demographics between the groups although a greater number of babies requiring early ligation had contraindication to indomethacin as the main reason for ligation. Early PDA ligation was associated with increased postoperative cardiotrope requirement (27.6 vs 5.6%, P ¼ 0.02) and decreased systolic blood pressure 8 h after intervention (P<0.05). Although increased oxygenation index was observed in both groups during the first 12 h it was only sustained to 24 h in the early group (P<0.05). Age at ligation remained a significant risk factor for postoperative cardiotrope requirement on multiple logistic regression analysis.Conclusion: Surgical ligation of the ductus arteriosus in preterm infants less than 28 days old is associated with oxygenation difficulties, decreased systolic arterial pressure and an increased need for cardiotropic support in the initial 24 postoperative hours. These data suggest the need to prospectively characterize perioperative cardiovascular physiology and identify predictive factors of clinical deterioration.

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Incidence of vocal fold paralysis in infants undergoing ligation of patent ductus arteriosus

Cited by 147 publications

References 5 publications

Unilateral Vocal Fold Paralysis After Congenital Cardiothoracic Surgery: A Meta-analysis

Unilateral Vocal Fold Paralysis After Congenital Cardiothoracic Surgery: A Meta-analysis

Patent ductus arteriosus in the preterm infant: to treat or not to treat?

Postoperative cardiorespiratory instability following ligation of the preterm ductus arteriosus is related to early need for intervention

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