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Patent ductus arteriosus in preterm infant

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https://www.readbyqxmd.com/read/28264088/association-of-patent-ductus-arteriosus-ligation-with-death-or-neurodevelopmental-impairment-among-extremely-preterm-infants
#1
Dany E Weisz, Lucia Mirea, Erin Rosenberg, Maximus Jang, Linh Ly, Paige T Church, Edmond Kelly, S Joseph Kim, Amish Jain, Patrick J McNamara, Prakesh S Shah
Importance: Observational studies have associated patent ductus arteriosus (PDA) ligation among preterm infants with adverse neonatal outcomes and neurodevelopmental impairment in early childhood, with a resultant secular trend away from surgical treatment. However, to our knowledge, studies have inadequately addressed sources of residual bias, including survival bias and major neonatal morbidities arising before exposure to ligation. Objective: Evaluate the association between PDA ligation vs medical management and neonatal and neurodevelopmental outcomes...
March 6, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28258737/association-between-use-of-prophylactic-indomethacin-and-the-risk-for-bronchopulmonary-dysplasia-in-extremely-preterm-infants
#2
Erik A Jensen, Kevin C Dysart, Marie G Gantz, Benjamin Carper, Rosemary D Higgins, Martin Keszler, Matthew M Laughon, Brenda B Poindexter, Barbara J Stoll, Michele C Walsh, Barbara Schmidt
OBJECTIVE: To assess the association between prophylactic indomethacin and bronchopulmonary dysplasia (BPD) in a recent, large cohort of extremely preterm infants. STUDY DESIGN: Retrospective cohort study using prospectively collected data for infants with gestational ages < 29 weeks or birth weights of 401-1000 g born between 2008 and 2012 at participating hospitals of the National Institute of Child Health and Human Development Neonatal Research Network...
February 28, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28225202/cardiac-remodeling-in-preterm-infants-with-prolonged-exposure-to-a-patent-ductus-arteriosus
#3
Koert de Waal, Nilkant Phad, Nick Collins, Andrew Boyle
BACKGROUND: Sustained volume load due to a patent ductus arteriosus (PDA) leads to cardiac remodeling. Remodeling changes can become pathological and are associated with cardiovascular disease progression. Data on remodeling changes in preterm infants is not available. METHODS: Clinical and echocardiography data were collected in preterm infants <30 weeks gestation on postnatal day 3 and then every 7-14 days until closure of the ductus arteriosus. Images were analyzed using conventional techniques and speckle tracking...
February 22, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28196391/pentoxifylline-treatment-of-very-low-birth-weight-neonates-with-nosocomial-sepsis
#4
Şahin Hamilçıkan, Emrah Can, Övgü Büke, Meltem Erol, Özlem Bostan Gayret
Objective The objective of this study was to assess the result of intravenous pentoxifylline as an adjunct to antibiotic therapy on mortality and morbidity in very low birth weight (VLBW) preterm neonates with nosocomial sepsis. Methods For the 18 VLBW preterm neonates, as an adjunct therapy to antibiotics regimens, pentoxifylline (5 mg/kg/h for 6 hours) was administered to premature infants with sepsis on 3 successive days. Clinical and laboratory parameters were recorded before and after treatment. Results Following pentoxifylline therapy, the immature-to-total neutrophil ratio and C-reactive protein (CRP) levels were significantly decreased, while the blood pH and base excess were significantly increased (p < 0...
February 14, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28139441/normative-values-of-aortic-arch-structures-in-premature-infants
#5
Elles J Dijkema, Mirella C Molenschot, Johannes M P J Breur, Willem B de Vries, Martijn G Slieker
BACKGROUND: Aortic arch abnormalities represent 5% to 8% of all congenital heart disease. Measurements of the aortic arch dimensions on two-dimensional echocardiographic images remain of critical importance in the diagnosis of aortic arch pathology. To define aortic hypoplasia or coarctation, measured dimensions must be compared with normal values. Normal values have been described for children of all ages in earlier studies. However, normative data for premature infants are not yet available...
March 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28125815/patent-ductus-arteriosus-treatment-in-very-preterm-infants-a-european-population-based-cohort-study-epice-on-variation-and-outcomes
#6
Anna-Karin Edstedt Bonamy, Anna Gudmundsdottir, Rolf F Maier, Liis Toome, Jennifer Zeitlin, Mercedes Bonet, Alan Fenton, Asbjørn Børch Hasselager, Arno van Heijst, Ludwig Gortner, David Milligan, Patrick Van Reempts, Elaine M Boyle, Mikael Norman
BACKGROUND: Spontaneous closure of patent ductus arteriosus (PDA) occurs frequently in very preterm infants and despite the lack of evidence for treatment benefits, treatment for PDA is common in neonatal medicine. OBJECTIVES: The aim of this work was to study regional variations in PDA treatment in very preterm infants (≤31 weeks of gestation), its relation to differences in perinatal characteristics, and associations with bronchopulmonary dysplasia (BPD) and survival without major neonatal morbidity...
January 26, 2017: Neonatology
https://www.readbyqxmd.com/read/28115028/post-transitional-adaptation-of-the-left-heart-in-uncomplicated-very-preterm-infants
#7
Koert De Waal, Nilkant Phad, Anil Lakkundi, Peter Tan
BACKGROUND: The postnatal period in preterm infants involves multiple physiological changes occurring immediately after birth and continuing for days or weeks. To recognise and treat compromise, it is important to measure cardiovascular function. The aim of this study was to describe longitudinal left ventricular function using conventional and novel echocardiography techniques in preterm infants who did not experience significant antenatal or postnatal complications and treatments. METHODS: We prospectively obtained cardiac ultrasound images at days 3, 7, 14, 21, and 28 in 25 uncomplicated, preterm infants <30 weeks of gestation...
January 24, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28102857/vocal-fold-paralysis-in-preterm-infants-prevalence-and-analysis-of-risk-factors
#8
J Jabbour, M Uhing, T Robey
OBJECTIVE: To calculate the prevalence of vocal fold paralysis (VFP) in preterm (<37 weeks of gestation) infants at a single neonatal intensive care unit (NICU) and identify risk factors for the development of VFP. STUDY DESIGN: This is a case control study of all surviving preterm infants admitted to the NICU at Children's Hospital of Wisconsin from 2006 to 2012, comparing those with and without VFP. Multivariate analysis was performed to identify significant risk factors for VFP...
January 19, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28099422/relationship-between-perfusion-index-and-patent-ductus-arteriosus-in-preterm-infants
#9
Enrique Gomez-Pomar, Majd Makhoul, Philip M Westgate, Katrina T Ibonia, Abhijit Patwardhan, Peter J Giannone, Henrietta Bada, Elie G Abu Jawdeh
BACKGROUND: Perfusion index (PI) is a noninvasive measure of perfusion. ΔPI (difference between pre and post-ductal PI) may identify hemodynamically significant PDA. However, studies are limited to brief and intermittent ΔPI sampling. Our objective is to assess the value of continuous high resolution ΔPI monitoring in the diagnosis of PDA. METHODS: Continuous ΔPI monitoring in preterm infants was prospectively performed using two high resolution pulse oximeters...
January 18, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28052714/efficacy-and-safety-of-rectal-ibuprofen-for-patent-ductus-arteriosus-closure-in-very-low-birth-weight-preterm-infants
#10
Nihat Demir, Erdal Peker, İbrahim Ece, Ragıp Balahoroğlu, Oğuz Tuncer
BACKGROUND: To compare rectal ibuprofen with oral ibuprofen for the closure of hemodynamically significant patent ductus arteriosus (hsPDA) in very low birth weight (VLBW) preterm infants. STUDY DESIGN AND SUBJECTS: In a prospective, randomized study, 72 VLBW infants who had hsPDA received either rectal or oral ibuprofen. The plasma concentration of ibuprofen and renal functions were determined in both groups by the high-performance liquid chromatography (HPLC) method and cystatin-C (cys-C), respectively...
January 25, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28046188/comparative-effectiveness-of-nonsteroidal-anti-inflammatory-drug-treatment-vs-no-treatment-for-patent-ductus-arteriosus-in-preterm-infants
#11
Jonathan L Slaughter, Patricia B Reagan, Thomas B Newman, Mark A Klebanoff
Importance: Patent ductus arteriosus (PDA) is associated with increased mortality and worsened respiratory outcomes, including bronchopulmonary dysplasia (BPD), in preterm infants. Nonsteroidal anti-inflammatory drugs (NSAIDs) are efficacious in closing PDA, but the effectiveness of NSAID-mediated PDA closure in improving mortality and preventing BPD is unclear. Objective: To determine the effectiveness of NSAID treatment for PDA in reducing mortality and moderate/severe BPD at 36 weeks postmenstrual age...
March 6, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28042972/a-conservative-treatment-of-patent-ductus-arteriosus-in-very-low-birth-weight-infants
#12
J B Letshwiti, J Semberova, K Pichova, E M Dempsey, O M Franklin, J Miletin
BACKGROUND: Treatment of the patent ductus arteriosus (PDA) in the preterm infant remains contentious. There are numerous options of the PDA management from early targeted treatment, late (symptomatic) treatment to no treatment at all. AIMS: To evaluate a three different PDA management approaches in very low birth weight (VLBW) infants. STUDY DESIGN: A retrospective observational time series study of three cohorts of VLBW infants born between 2004 and 2011...
January 2017: Early Human Development
https://www.readbyqxmd.com/read/28041866/-management-of-patent-ductus-arteriosus-in-preterm-infants-an-evidence-based-approach
#13
V Gournay
A patent ductus arteriosus, very common in the preterm infant (incidence up to 70% in infants less than 28 weeks gestational age), causes a left-to-right shunt leading to overload of the pulmonary circulation and low systemic blood flow. These hemodynamic anomalies are associated with a higher incidence of respiratory, neurological, and digestive complications of prematurity, as well as a higher mortality rate. Although growing knowledge about the natural history, the pathophysiology, and the mechanisms of closure of the ductus arteriosus has resulted in therapeutic progress, management of the patent ductus arteriosus in the preterm infant is still a subject of intense controversy...
February 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27998626/cardiac-biomarkers-and-haemodynamically-significant-patent-ductus-arteriosus-in-preterm-infants
#14
Dany E Weisz, Patrick J McNamara, Afif El-Khuffash
Accurately defining haemodynamically significant patent ductus arteriosus (PDA) in preterm infants who are at risk of PDA related morbidities are active areas of neonatal research. Natriuretic peptides are cardiac hormones that respond to volume and pressure loading, with elevated plasma levels found in infants with PDA. In the preterm neonatal setting, studies to date have predominantly investigated the ability of these biomarkers to discriminate between infants with and without a PDA at various postnatal ages...
December 17, 2016: Early Human Development
https://www.readbyqxmd.com/read/27960245/bronchodilators-for-the-prevention-and-treatment-of-chronic-lung-disease-in-preterm-infants
#15
REVIEW
Geraldine Ng, Orlando da Silva, Arne Ohlsson
BACKGROUND: Chronic lung disease (CLD) occurs frequently in preterm infants. Bronchodilators have the potential effect of dilating small airways with muscle hypertrophy. Increased compliance and tidal volume and decreased pulmonary resistance have been documented with the use of bronchodilators in infants with CLD. Therefore, bronchodilators might have a role in the prevention and treatment of CLD. OBJECTIVES: To determine the effect of bronchodilators given as prophylaxis or as treatment for CLD on mortality and other complications of preterm birth in infants at risk for or identified as having CLD...
December 14, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27936395/population-based-report-on-health-related-quality-of-life-in-adolescents-born-very-preterm
#16
Giancarlo Natalucci, Hans Ulrich Bucher, Michael Von Rhein, Cristina Borradori Tolsa, Beatrice Latal, Mark Adams
BACKGROUND: As the survival rate of preterm infants constantly improves, knowledge on the impact of prematurity on long-term health-related quality of life (HRQoL) is important for clinical and parental guidance. We aimed to assess HRQoL in a national cohort of young adolescents born very preterm, and to identify predictors for poorer HRQoL. PATIENTS AND METHODS: All surviving Swiss live-born children below 30weeks of gestation during the year 2000 (290 subjects) were contacted at age 12years, together with their parents (262 families)...
December 6, 2016: Early Human Development
https://www.readbyqxmd.com/read/27915200/effects-of-prophylactic-indomethacin-on-vasopressor-dependent-hypotension-in-extremely-preterm-infants
#17
Melissa Liebowitz, Jane Koo, Andrea Wickremasinghe, Isabel Elaine Allen, Ronald I Clyman
OBJECTIVE: To determine whether a moderate-to-large patent ductus arteriosus (PDA) is responsible for vasopressor-dependent hypotension, occurring at the end of the first postnatal week. STUDY DESIGN: We performed a retrospective, double cohort controlled study of infants delivered at ≤27(+6) weeks' gestation (n = 313). From January 2004 through April 2011, all infants were treated with prophylactic indomethacin ([PINDO] epoch). From May 2011 through December 2015, no infant was treated with indomethacin until at least 8 postnatal days (conservative epoch)...
March 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/27914140/comparison-of-the-mortality-and-in-hospital-outcomes-of-preterm-infants-treated-with-ibuprofen-for-patent-ductus-arteriosus-with-or-without-clinical-symptoms-attributable-to-the-patent-ductus-arteriosus-at-the-time-of-ibuprofen-treatment
#18
Hani Yoo, Jin A Lee, Sohee Oh, Young Hwa Jung, Jin A Sohn, Seung Han Shin, Chang Won Choi, Ee Kyung Kim, Han Suk Kim, Beyong Il Kim
The aim of this study was to assess the differences in the mortality and in-hospital outcomes of preterm infants with < 28 weeks of gestation who received ibuprofen treatment according to the presence of clinical symptoms (any of oliguria, hypotension, or moderate to severe respiratory difficulty) attributable to hemodynamically-significant patent ductus arteriosus (hsPDA) at the time of first ibuprofen treatment. In total, 91 infants born from April 2010 to March 2015 were included. Fourteen infants (15...
January 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27892517/chorioamnionitis-appears-not-to-be-a-risk-factor-for-patent-ductus-arteriosus-in-preterm-infants-a-systematic-review-and-meta-analysis
#19
Elham Behbodi, Eduardo Villamor-Martínez, Pieter L J Degraeuwe, Eduardo Villamor
The contribution of chorioamnionitis (CA) to mortality and morbidity in preterm infants is difficult to assess because observational studies frequently present significant differences in baseline characteristics of the infants exposed or non-exposed to CA. In an attempt to perform a thorough assessment of the possible association between CA and patent ductus arteriosus (PDA) in preterm infants, we conducted a meta-analysis in which adjusted odds ratios (ORs) were pooled and we analyzed the effects of potential confounders, such as gestational age (GA) or birth weight (BW)...
November 28, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27860173/novel-use-of-the-medtronic-micro-vascular-plug-for-pda-closure-in-preterm-infants
#20
Elizabeth W Wang-Giuffre, John P Breinholt
OBJECTIVES: To describe a single institution experience with a new endovascular occlusion device used for transcatheter patent ductus arteriosus (PDA) closure in preterm infants. BACKGROUND: The PDA is a defect largely treated via cardiac catheterization except for the smallest patients. METHODS: Medical records and catheterization reports of all premature neonates who underwent PDA device closure with the Medtronic Micro Vascular Plug (MVP) (Medtronic, Minneapolis, MN) between September 2015 and June 2016 were reviewed...
November 10, 2016: Catheterization and Cardiovascular Interventions
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