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Patent ductus arteriosus in preterm infant

Stephanie Prescott, Jessica Keim-Malpass
BACKGROUND: The incidence of hemodynamically significant patent ductus arteriosus (hsPDA) increases with decreasing gestational age and is associated with many common morbidities of extreme prematurity. Controversies remain surrounding the definition of hsPDA, the population of infants requiring treatment, the appropriate timing and method of treatment, and the outcomes associated with PDA and its therapies. PURPOSE: This integrative literature review focuses on diagnostic and treatment recommendations derived from the highest levels of evidence...
October 8, 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Joseph M Collaco, Gul H Dadlani, Melanie K Nies, Jenny Leshko, Allen D Everett, Sharon A McGrath-Morrow
BACKGROUND: Pulmonary hypertension (PH) is a significant cause of morbidity in preterm infants, but no screening guidelines exist. We sought to identify risk factors and clinical outcomes associated with PH in preterm infants to develop a PH risk score. METHODS: Retrospective analysis of two separate populations of preterm infants (NICU cohort n = 230; Clinic registry n = 580). RESULTS: 8.3% of the NICU cohort had PH after 4 weeks of age, while 14...
2016: PloS One
Mohammad Mehdi Bagheri, Pedram Niknafs, Fatemeh Sabsevari, Mohammad Hosein Torabi, Bahareh Bahman Bijari, Elahe Noroozi, Hamid Mossavi
BACKGROUND: Patent ductus arteriosus (PDA) is a common cause of morbidity. The aim of this study was to compare the efficacy of oral Acetaminophen and oral Ibuprofen for the closure of patent ductus arteriosus (PDA) in preterm infants. OBJECTIVES: This study demonstrated that, there was no significant difference between treatment of PDA with either oral Acetaminophen or oral Ibuprofen in preterm neonates. PATIENTS AND METHODS: This clinical trial, randomized study, enrolled 120 infants, with a gestational age of < 37 weeks, who were admitted in neonatal intensive care unit of Afzalipour hospital, Kerman, Iran, in 2014...
August 2016: Iranian Journal of Pediatrics
Crista A Hopp, Ida Sue Baron
OBJECTIVE: Children delivered at the edge of viability are at greatest risk of medical and neuropsychological disability, their adverse outcomes overshadowing extremely preterm survivors with more optimal outcomes. We aimed to describe an exceptionally early-born extremely preterm (EEEP) preschooler whose neurobiological, familial, and socioeconomic factors likely influenced her unexpected cognitive resilience. METHOD: Baby G was a 3-years 10-months-old, English-speaking, Caucasian, singleton girl born weighing 435 g at 22(5/7) weeks' gestation to well-educated married parents...
October 5, 2016: Clinical Neuropsychologist
Bo Yang, Xiangyu Gao, Yi Ren, Yun Wang, Qinglin Zhang
The aim of the present study was to analyze the changes of plasma and urinary prostaglandin E2 (PGE2) levels in preterm infants with symptomatic patent ductus arteriosus (sPDA) treated with oral ibuprofen and acetaminophen. A total of 87 preterm infants with sPDA admitted to the Neonatal Ward of the Affiliated Xuzhou Hospital of Medical College of Southeast University from October, 2012 to June, 2015 were selected and randomly divided into the ibuprofen group (n=43, 10 mg/kg ibuprofen administered orally as initial dose, followed by 5 mg/kg during the first 24 and 48 h later) and acetaminophen group (n=44, 15 mg/kg acetaminophen administered orally once every 6 h for three days)...
October 2016: Experimental and Therapeutic Medicine
Shujiro Fujita, Utako Yokoyama, Ryo Ishiwata, Rika Aoki, Kenji Nagao, Daiki Masukawa, Masanari Umemura, Takayuki Fujita, Shiho Iwasaki, Shigeru Nishimaki, Kazuo Seki, Shuichi Ito, Yoshio Goshima, Toshihide Asou, Munetaka Masuda, Yoshihiro Ishikawa
BACKGROUND: Extremely preterm infants frequently have patent ductus arteriosus (PDA). Recent recommendations include immediately beginning amino acid supplementation in extremely preterm infants. However, the effect of amino acids on closure of the ductus arteriosus (DA) remains unknown.Methods and Results:Aminogram results in human neonates at day 2 revealed that the plasma glutamate concentration was significantly lower in extremely preterm infants (<28 weeks' gestation) with PDA than in those without PDA and relatively mature preterm infants (28-29 weeks gestation)...
September 21, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
Armend Lokku, Lucia Mirea, Shoo K Lee, Prakeshkumar S Shah
Objective To assess trends in patent ductus arteriosus (PDA) management and examine concurrent changes in neonatal mortality and morbidities. Methods This retrospective observational study examined infants born at 23 to 32 weeks' gestational age with PDA and admitted to a neonatal unit during 2006 to 2012. Multivariable logistic regression assessed trends in yearly PDA treatment rates and compared a composite outcome of mortality or any severe morbidity (bronchopulmonary dysplasia, intraventricular hemorrhage, periventricular leukomalacia, retinopathy of prematurity, or necrotizing enterocolitis) between and within time periods and PDA treatments...
September 20, 2016: American Journal of Perinatology
Valerie Y Chock, Laura A Rose, Jeanet V Mante, Rajesh Punn
BACKGROUND: Near-infrared spectroscopy (NIRS) may assist with characterization of a hemodynamically significant patent ductus arteriosus (hsPDA) by measuring cerebral and renal saturation (Csat and Rsat) levels. We hypothesized that Csat and Rsat in preterm infants with an hsPDA would be decreased compared to those with no PDA or non-significant PDA. METHODS: This non a-priori designed study retrospectively investigated clinical and ECHO characteristics of preterm infants <29 weeks gestation who underwent routine NIRS monitoring...
September 7, 2016: Pediatric Research
Masayuki Ochiai, Hiroaki Kurata, Hirosuke Inoue, Koichi Tanaka, Yuki Matsushita, Junko Fujiyoshi, Yoshifumi Wakata, Kiyoko Kato, Tomoaki Taguchi, Hidetoshi Takada
BACKGROUND: The substantial risk of iron overload is not routinely monitored in most of the neonatal intensive care units (NICUs) in Japan; however, blood transfusion is an essential strategy for successfully treating preterm low-birth-weight infants. OBJECTIVE: The aim of this study was to investigate the iron status and clinical features of infants with a birth weight of <1,500 g, i.e. very-low-birth-weight infants (VLBWIs). METHODS: This prospective observational study enrolled 176 (82...
August 23, 2016: Neonatology
Kok Pim Kua, Shaun Wen Huey Lee
AIMS: This study evaluated the therapeutic outcomes of early versus late caffeine therapy in preterm neonates. METHODS: We performed a systematic literature search in PubMed, Embase, CINAHL and CENTRAL from inception to 30 June 2016 to identify studies investigating the use of early caffeine therapy (initiated at less than 3 days of life) in preterm infants. Effect estimates were combined using random-effects meta-analysis. The primary outcomes for this study were bronchopulmonary dysplasia and mortality...
August 15, 2016: British Journal of Clinical Pharmacology
James I Hagadorn, Elizabeth A Brownell, Jennifer M Trzaski, Kendall R Johnson, Shabnam Lainwala, Brendan T Campbell, Katherine W Herbst
BACKGROUND: We examined recent trends and interhospital variation in use of indomethacin, ibuprofen, and surgical ligation for PDA in VLBW infants. METHODS: Included in this retrospective study of the Pediatric Hospital Information System database were 13,853 VLBW infants from 19 US children's hospitals, admitted at age < 3 days between January 1, 2005 and December 31, 2014. PDA management and in-hospital outcomes were examined for trends and variation. RESULTS: PDA was diagnosed in 5,719 (42%) VLBW infants...
August 10, 2016: Pediatric Research
Behrouz Banieghbal
BACKGROUND: In preterm infants, immediate complications of surgical closure of a patent ductus arteriosus (PDA) are often serious and due to haemorrhage or ligation of incorrect structures. The aim of this study was to measure blood pressure (BP) changes during ligation and hence introduce a novel physiological marker to alert surgeons to the ligation of incorrect structures. MATERIALS AND METHODS: This study included 146 preterm babies (≤35 weeks of gestation) who underwent surgical PDA closure of a left-to-right unidirectional PDA between June 2006 and December 2015...
July 2016: African Journal of Paediatric Surgery: AJPS
Michelle E van der Laan, Marcus T R Roofthooft, Marian W A Fries, Trijntje E Schat, Arend F Bos, Rolf M F Berger, Elisabeth M W Kooi
OBJECTIVES: Cardiac output may be compromised in preterm infants with sepsis. Whether low cardiac output is associated with low tissue oxygen supply in these patients is unclear. The aim of the current study was to assess the association between cardiac output, assessed by echocardiography, and tissue oxygenation, measured with multisite near-infrared spectroscopy, in a cohort of preterm infants with clinical sepsis. DESIGN: Prospective observational cohort study...
August 2016: Pediatric Critical Care Medicine
Maarja Hallik, Tõnis Tasa, Joel Starkopf, Tuuli Metsvaht
BACKGROUND: Milrinone has been suggested as a possible first-line therapy for preterm neonates to prevent postligation cardiac syndrome (PLCS) through decreasing systemic vascular resistance and increasing cardiac contractility. The optimal dosing regimen, however, is not known. OBJECTIVE: To model the dosing of milrinone in preterm infants for prevention of PLCS after surgical closure of patent ductus arteriosus (PDA). METHODS: Milrinone time-concentration profiles were simulated for 1,000 subjects using the volume of distribution and clearance estimates based on one compartmental population pharmacokinetic model by Paradisis et al...
August 5, 2016: Neonatology
Shahnaz Pourarian, Nazanin Farahbakhsh, Deepak Sharma, Sirous Cheriki, Farhad Bijanzadeh
BACKGROUND: Patent ductus arteriosus (PDA) is a common problem in the preterm infants. The frequency of PDA varies with the time of study, and the characteristics of the population included in the trial. AIMS AND OBJECTIVE: To determine the prevalence and prenatal risk factor associated with PDA. METHODS AND MATERIAL: This prospective cross-sectional observational study was carried out on neonates who had gestational age below 37 weeks during the period of February 2014 to September 2014...
August 25, 2016: Journal of Maternal-fetal & Neonatal Medicine
Qiuping Li, Zhichun Feng
No abstract text is available yet for this article.
January 2016: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Souvik Mitra, Ivan D Florez, Maria E Tamayo, Dagfinn Aune, Lawrence Mbuagbaw, Areti-Angeliki Veroniki, Lehana Thabane
INTRODUCTION: Management of patent ductus arteriosus (PDA) in preterm infants is one of the most controversial topics in neonatal medicine. The availability of different pharmacotherapeutic options often poses a practical challenge to the practising neonatologist as to which one to choose as a therapeutic option. Our objectives are to determine the relative merits of the available pharmacotherapeutic options for the management of PDA. METHODS AND ANALYSIS: We will conduct a systematic review of all randomised controlled trials evaluating the use of intravenous or oral: indomethacin, ibuprofen and acetaminophen for the treatment of PDA in preterm infants...
July 25, 2016: BMJ Open
Se In Sung, Yun Sil Chang, Ji Young Chun, Shin Ae Yoon, Hye Soo Yoo, So Yoon Ahn, Won Soon Park
OBJECTIVE: To determine whether a nonintervention approach for treating hemodynamically significant patent ductus arteriosus (PDA) is associated with decreased mortality and/or morbidity compared with a mandatory closure approach in extremely low birth weight infants. STUDY DESIGN: We reviewed the medical records of 178 infants of 23-26 weeks' gestational age with PDA, requiring ventilator treatment, and with hemodynamically significant PDA ≥2 mm in size. Mandatory closure was used during period I (July 2009 to December 2011, n = 81), and nonintervention was used during period II (January 2012 to June 2014, n = 97)...
October 2016: Journal of Pediatrics
Maria I Durães, Filipa Flor-DE-Lima, Gustavo Rocha, Henrique Soares, Hercília Guimarães
BACKGROUND: Extreme preterm infants have a high risk of morbidity and mortality. Newborns delivered between 23+0 and 25+6 weeks, are considered to be in the "gray zone" and have uncertain prognosis. For these children medical decision-making becomes complex and controversial. The present study intends to evaluate the neonatal morbidity and mortality of preterm infants born between 23 weeks and 25+6 weeks of gestational age. METHODS: A retrospective study was conducted including all inborn preterm infants, with a gestational age between 23+0 and 25+6 weeks, admitted to a level IIIC NICU, between 1st January, 1996 and 31th December, 2014...
July 13, 2016: Minerva Pediatrica
Odile Frauenfelder, Ingrid M van Beynum, Irwin K M Reiss, Sinno H P Simons
Ibuprofen is a well-known agent used to treat patent ductus arteriosus in preterm neonates in the first days of life. In the current case report we illustrate the potential use of ibuprofen in two preterm neonates 60 and 88 days after birth, respectively. To our knowledge, this is the first report on the effects of ibuprofen on patent ductus arteriosus in preterm newborns after months of life. These cases suggest that the ductus arteriosus does not become refractory for ibuprofen after the first days of life...
2016: Case Reports in Pediatrics
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