Patent Ductus Arteriosus in Premature Infants: Clinical Trials and Equipoise

Liguori, M; Ali, Sanoj K M; Colaizy, Tarah T.; Hundscheid, Tim; Phad, Nilkant; Clyman, Ronald I.; Boode, Willem P. de; Waal, Koert de; El-Khuffash, Afif; Gupta, Samir; Laughon, Matthew M.

doi:10.1016/j.jpeds.2023.113532

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2024

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Cited by 3 publications

References 60 publications

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Effect of chest shielding during phototherapy for hyperbilirubinemia on symptomatic patent ductus arteriosus – a double-blind randomized placebo-controlled trial

Mannan,

Amin

2024

Pediatr Res

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Effect of chest shielding during phototherapy for hyperbilirubinemia on symptomatic patent ductus arteriosus – a double-blind randomized placebo-controlled trial

Mannan,

Amin

2024

Pediatr Res

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Beneficial vs harmful effects of pharmacological treatment of patent ductus arteriosus: A Bayesian meta-analysis

Villamor,

Galán-Henríquez,

Bartoš

et al. 2024

Preprint

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BackgroundRandomized controlled trials (RCTs) have failed to demonstrate beneficial effects of the pharmacological treatment of patent ductus arteriosus (PDA) in preterm infants. We conducted a Bayesian model averaged (BMA) meta-analysis of RCTs comparing pharmacological treatment of PDA with placebo or expectant treatment.MethodsWe searched for RCTs including infants with gestational age (GA) ≤32 weeks and with a rate of open-label treatment of less than 25% in the control arm. Primary outcome was mortality and secondary outcomes included bronchopulmonary dysplasia (BPD). We calculated Bayes factors (BFs). The BF+/-is the ratio of the probability of the data under H+(pharmacological treatment is beneficial) over the probability of the data under H-(pharmacological treatment is harmful).ResultsFive RCTs were included (1341 infants). BMA showed strong evidence in favor of a harmful effect of medication for BPD (BF+/-=0.02) and BPD or death (BF+/-=0.03). When the two largest trials, which used early (<72 h) ibuprofen in infants with GA ≤28 weeks, were pooled, the BMA demonstrated moderate evidence in favor of higher mortality in the medication group (BF+/-=0.24).ConclusionsEarly ibuprofen treatment of a PDA in extremely preterm infants may result in more complications than clinical benefit.

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Pulmonary Hypertension and Lung Damage Associated with Prolonged Exposure to Patent Ductus Arteriosus in Very Preterm Infants

Villamor,

Gonzalez-Luis

2024

Am J Respir Crit Care Med

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Patent Ductus Arteriosus in Premature Infants: Clinical Trials and Equipoise

Cited by 3 publications

References 60 publications

Effect of chest shielding during phototherapy for hyperbilirubinemia on symptomatic patent ductus arteriosus – a double-blind randomized placebo-controlled trial

Effect of chest shielding during phototherapy for hyperbilirubinemia on symptomatic patent ductus arteriosus – a double-blind randomized placebo-controlled trial

Beneficial vs harmful effects of pharmacological treatment of patent ductus arteriosus: A Bayesian meta-analysis

Pulmonary Hypertension and Lung Damage Associated with Prolonged Exposure to Patent Ductus Arteriosus in Very Preterm Infants

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