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Patent ductus arteriosus in preterm infant

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https://www.readbyqxmd.com/read/28724506/the-use-of-non-steroidal-anti-inflammatory-drugs-for-patent-ductus-arteriosus-closure-in-preterm-infants
#1
REVIEW
William E Benitz, Shazia Bhombal
Over the last four decades, non-steroidal anti-inflammatory drugs have been widely used to induce closure of the patent ductus arteriosus (PDA) in preterm infants. Evidence to support this practice is lacking, despite performance of >50 randomized trials. The credibility of those trials may have been compromised by high rates of open treatment in controls, era of study prior to advent of modern practices, or inclusion of insufficient numbers of very immature infants. Meta-analyses show little impact of those factors on main conclusions...
July 17, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28723921/postnatal-dexamethasone-respiratory-and-neurodevelopmental-outcomes-at-two-years-in-babies-born-extremely-preterm
#2
Gordon Qin, Jessica W Lo, Neil Marlow, Sandy A Calvert, Anne Greenough, Janet L Peacock
IMPORTANCE: Postnatal dexamethasone is associated with reduction in bronchopulmonary dysplasia. There remains, however, concern that its short-term benefits are accompanied by long-term adverse effects e.g. poorer neurodevelopmental outcomes. OBJECTIVE: Our aim was to determine the effects of administration of postnatal dexamethasone on respiratory and neurodevelopmental outcome at two years of age after adjusting for neonatal and infant risk factors. MATERIALS AND METHODS: The study included 412 infants born at 23-28 weeks of gestation, 29% had received postnatal dexamethasone...
2017: PloS One
https://www.readbyqxmd.com/read/28704836/abdominal-near-infrared-spectroscopy-detects-low-mesenteric-perfusion-early-in-preterm-infants-with-hemodynamic-significant-ductus-arteriosus
#3
Ana Ledo, Marta Aguar, Antonio Núñez-Ramiro, Pilar Saénz, Máximo Vento
BACKGROUND: The therapeutic decision to close patent ductus arteriosus in preterm infants entails great uncertainty. Near-infrared spectroscopy is a noninvasive bedside technique used to monitor mixed regional oxygen saturation. We hypothesized that near-infrared spectroscopy could identify preterm infants at risk of mesenteric hypoperfusion associated with hemodynamically significant ductus arteriosus. METHODS: This is a prospective observational study including consecutively admitted preterm infants with a gestational age <32 weeks...
July 14, 2017: Neonatology
https://www.readbyqxmd.com/read/28704819/electrical-cardiometry-to-monitor-cardiac-output-in-preterm-infants-with-patent-ductus-arteriosus-a-comparison-with-echocardiography
#4
Kai-Hsiang Hsu, Tai-Wei Wu, I-Hsyuan Wu, Mei-Yin Lai, Shih-Yun Hsu, Hsiao-Wen Huang, Tze-Yee Mok, Reyin Lien
BACKGROUND: Electrical cardiometry (EC) is an impedance-based monitoring that provides noninvasive cardiac output (CO) assessment. Through comparison to transthoracic echocardiography (Echo), the accuracy of EC has been verified. However, left-to-right patent ductus arteriosus (PDA) shunting is a concern because PDA shunts aortic flow to the pulmonary artery and may interfere with EC in measuring CO. OBJECTIVE: To determine the agreement between EC and Echo in preterm infants with a hemodynamically significant PDA (hsPDA)...
July 14, 2017: Neonatology
https://www.readbyqxmd.com/read/28697406/efficacy-of-pharmacologic-closure-of-patent-ductus-arteriosus-in-small-for-gestational-age-extremely-preterm-infants
#5
Nansi S Boghossian, Barbara T Do, Edward F Bell, John M Dagle, Jane E Brumbaugh, Barbara J Stoll, Betty R Vohr, Abhik Das, Seetha Shankaran, Pablo J Sanchez, Myra H Wyckoff, M Bethany Ball
BACKGROUND: Optimal management of the patent ductus arteriosus (PDA) in preterm infants remains controversial. Therefore, studies identifying infants who are most likely to benefit from PDA treatment are needed. AIM: We sought to examine if significant intrauterine growth restriction, defined by birth weight z-score, reduces the efficacy of PDA closure with indomethacin or ibuprofen and thereby increases the need for surgical closure of PDA after pharmacologic treatment...
July 8, 2017: Early Human Development
https://www.readbyqxmd.com/read/28690644/individualized-ibuprofen-treatment-using-serial-b-type-natriuretic-peptide-measurement-for-symptomatic-patent-ductus-arteriosus-in-very-preterm-infants
#6
Jeonghee Shin, Eun Hee Lee, Jee Hyun Lee, Byung Min Choi, Young Sook Hong
PURPOSE: Plasma level of B-type natriuretic peptide (BNP), an emerging, sensitive, and specific biomarker of hemodynamically significant patent ductus arteriosus (PDA), rapidly decreases in infants receiving cyclooxygenase inhibitors for ductal closure. We investigated the usefulness of serial BNP measurement as a guide for individual identification of early constrictive responses to ibuprofen in preterm infants with symptomatic PDA (sPDA). METHODS: Before March 2010, the standard course of pharmacological treatment was initiated with indomethacin (or ibuprofen) and routinely followed by 2 additional doses at intervals of 24 hours...
June 2017: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/28688160/unilateral-vocal-cord-paralysis-after-surgical-closure-of-a-patent-ductus-arteriosus-in-extremely-preterm-infants
#7
Pramod Pharande, Sathiyapriya Karthigeyan, Karen Walker, Daphne D'Cruz, Nadia Badawi, Melissa Luig, David Winlaw, Himanshu Popat
AIM: Left vocal cord paralysis (LVCP) is variably reported post ligation of patent ductus arteriosus (PDA). Our objective was to determine the incidence of LVCP and identify predictive factors and associated morbidities in preterm infants post PDA ligation. METHODS: This is a retrospective cohort study of infants less than 29 weeks gestational age from 2006 to 2014 who underwent PDA ligation. Infants with laryngeal symptoms underwent flexible fibreoptic nasopharyngolaryngoscopy to evaluate vocal cord function...
July 8, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28684649/neonatal-outcomes-of-preterm-or-very-low-birth-weight-infants-over-a-decade-from-queen-mary-hospital-hong-kong-comparison-with-the-vermont-oxford-network
#8
Y Y Chee, M Sc Wong, R Ms Wong, K Y Wong
INTRODUCTION: There is a paucity of local data on neonatal outcomes of preterm/very-low-birth-weight infants in Hong Kong. This study aimed to evaluate the survival rate on discharge and morbidity of preterm/very-low-birth-weight infants (≤29+6 weeks and/or birth weight <1500 g) over a decade at Queen Mary Hospital in Hong Kong, so as to provide centre-specific data for prenatal counselling and to benchmark these results against the Vermont Oxford Network. METHODS: Standardised perinatal/neonatal data were collected for 449 infants with gestational age of 23+0 to 29+6 weeks and/or birth weight of <1500 g who were born at Queen Mary Hospital between 1 January 2005 and 31 December 2014...
July 7, 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/28680875/echocardiographic-evaluation-of-patent-ductus-arteriosus-in-preterm-infants
#9
REVIEW
Romaine Arlettaz
Patent ductus arteriosus (PDA) is part of the typical morbidity profile of the preterm infant, with a high incidence of 80-90% in extremely low birth weight infants born before 26 weeks of gestation. Whereas spontaneous closure of the ductus arteriosus (DA) is likely in term infants, it is less so in preterm ones. PDA is associated with increased mortality and various comorbidities including cardiac failure, need for respiratory support, bronchopulmonary dysplasia, pulmonary or intracranial hemorrhage, and necrotizing enterocolitis; however, there is no proven causality between these morbidities and the presence of DA...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28658134/treprostinil-for-persistent-pulmonary-hypertension-of-the-newborn-with-early-onset-sepsis-in-preterm-infant-2-case-reports
#10
Bo Young Park, Sung-Hoon Chung
RATIONALE: Persistent pulmonary hypertension of the newborn (PPHN) is a syndrome of failed circulatory adaptation at birth with persisting increased pulmonary vascular resistance that is associated with high mortality rates especially in preterm infants. PATIENT CONCERNS: We reported 2 cases of PPHN in preterm infants with respiratory distress syndrome and early onset sepsis refractory to therapy with vasopressors, inotropes, and inhaled nitric oxide (iNO), in whom treatment with treprostinil was successful...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28651469/morbidities-associated-with-patent-ductus-arteriosus-in-preterm-infants-nationwide-cohort-study
#11
Pia Härkin, Riitta Marttila, Tytti Pokka, Timo Saarela, Mikko Hallman
PURPOSE: To evaluate the predictive factors for the development of haemodynamically significant patent ductus arteriosus (PDA) in preterm infants and to study the morbidities associated with the treatment of PDA during the first hospitalization. MATERIALS AND METHODS: Data were collected from the Finnish national register of preterm infants (<32 gestational weeks) born in 2005-2013. In total, 3668 infants were included. Morbidities during the first hospitalization were analysed and compared between infants who received treatments for the closure of PDA (n = 1132) and infants who received no treatment for PDA (n = 2536)...
July 11, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28617424/outcomes-following-indomethacin-prophylaxis-in-extremely-preterm-infants-in-an-all-referral-nicu
#12
T D Nelin, E Pena, T Giacomazzi, S Lee, J W Logan, M Moallem, R Bapat, E G Shepherd, L D Nelin
OBJECTIVE: We examined data from a contemporary cohort of extreme prematurity (EP) infants admitted to an all-referral Children's Hospital neonatal intensive care unit (NICU) to determine whether prophylactic indomethacin (PI) may continue to benefit these patients. STUDY DESIGN: An observational study utilizing the small baby ICU data registry that was queried for all EP infants admitted between 2005 and 2014 with documentation of PI use (671 total EP infants; 141 (21%) did not receive PI (control); 530 (79%) received PI (PI)...
June 15, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28609430/polymorphisms-in-cyp2c9-are-associated-with-response-to-indomethacin-among-neonates-with-patent-ductus-arteriosus
#13
Caitlin J Smith, Kelli K Ryckman, Timothy M Bahr, John M Dagle
BackgroundPatent ductus arteriosus (PDA) is a common complication seen in preterm infants. Indomethacin is routinely used to treat PDA. Evidence suggests that the response of indomethacin is highly heritable. This study investigated the association between single-nucleotide polymorphisms (SNPs) in CYP2C9 and the closure of PDA in response to indomethacin.MethodsSix SNPs in CYP2C9 were analyzed for association with indomethacin response. A case-control analysis was performed among neonates who responded to indomethacin (responders) and among those who required surgical ligation (non-responders)...
July 5, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28596379/using-exhaled-co2-to-guide-initial-respiratory-support-at-birth-a-randomised-controlled-trial
#14
Ashley Y Ngan, Po-Yin Cheung, Ann Hudson-Mason, Megan O'Reilly, Sylvia van Os, Manoj Kumar, Khalid Aziz, Georg M Schmölzer
IMPORTANCE: A sustained inflation (SI) provided at birth might reduce bronchopulmonary dysplasia (BPD). OBJECTIVE: This study aims to examine whether an SI-guided exhaled carbon dioxide (ECO2) compared with positive pressure ventilation (PPV) alone at birth decreases BPD. DESIGN: Randomised controlled trial. Infants were randomly allocated to either SI (SI group) or PPV (PPV group). PARTICIPANTS: Participants of this study include infants between 23(+0) and 32(+6) weeks gestation with a need for PPV at birth...
June 8, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28553990/investigating-the-effects-of-cerebrospinal-fluid-removal-on-cerebral-blood-flow-and-oxidative-metabolism-in-infants-with-post-hemorrhagic-ventricular-dilatation
#15
Peter J McLachlan, Jessica Kishimoto, Mamadou Diop, Daniel Milej, David S C Lee, Sandrine de Ribaupierre, Keith St Lawrence
BackgroundPost-hemorrhagic ventricular dilatation (PHVD) is predictive of mortality and morbidity among very-low-birth-weight preterm infants. Impaired cerebral blood flow (CBF) due to elevated intracranial pressure (ICP) is believed to be a contributing factor.MethodsA hyperspectral near-infrared spectroscopy (NIRS) method of measuring CBF and the cerebral metabolic rate of oxygen (CMRO2) was used to investigate perfusion and metabolism changes in patients receiving a ventricular tap (VT) based on clinical management...
June 14, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28542663/-periorbital-pallor-post-application-of-mydriatic-in-infants-with-hydrocephalus-associated-to-systemic-effects
#16
Jorge Luis Alvarado Socarras, Sandra Consuelo Rodríguez
Adequate pupil dilation is needed to evaluate some neonates at risk of developing illness during this stage. However, this procedure is not free of adverse effects, either local or systemic. One of these complications is the local vasoconstriction of the preterm baby’s skin following the application of mydriatic eye drops. OBJECTIVE: To describe secondary local and systemic complications of pharmacological pupil dilation in 2 newborns. Clinical case 1: Full term baby with diagnosis of low-birth weight and hydrocephalia...
April 2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/28542659/-digestive-and-kidney-complications-by-indomethacin-and-ibuprofen-in-extreme-preterm-infants-with-patent-ductus-arteriosus
#17
Rodrigo Salas, Pablo Lavín, Yohanna Rincón, Juan Miranda, María López
The symptomatic patent ductus arteriosus (sPDA) is common in extremely premature infants (EPI). In order to decrease the hemodynamic repercussion and avoid complications it is necessary to close it. Indomethacin or ibuprofen are used for this purpose with its associated risks. OBJECTIVE: Characterize digestive and renal complications in EPI who received indomethacin or ibuprofen as sPDA treatment. PATIENTS AND METHOD: Retrospective study on EPI between January-2004 and December-2013...
April 2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/28469102/prevalence-of-congenital-heart-disease-among-infants-from-2012-to-2014-in-langfang-china
#18
Peng-Fei Sun, Gui-Chun Ding, Min-Yu Zhang, Sheng-Nan He, Yu Gao, Jian-Hua Wang
BACKGROUND: Congenital heart disease (CHD) is the most common congenital malformations with high mortality and morbidity. The prevalence of CHD reported previously ranged from 4 per 1000 live births to 50 per 1000 live births. In this cross-sectional study, we aimed to document the prevalence of CHD in Langfang district of Hebei Province, China by analyzing data collected by hospitals located in 11 the counties of the district, as supported by a public health campaign. METHODS: A total of 67,718 consecutive 3-month-old infants were included from July 19, 2012 to July 18, 2014...
May 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28468896/emergency-laparotomy-in-infants-born-at-26-weeks-gestation-a-neonatal-network-based-cohort-study-of-frequency-surgical-pathology-and-outcomes
#19
Jonathan Durell, Nigel J Hall, Melanie Drewett, Kujan Paramanantham, David Burge
OBJECTIVE: Identify the proportion of infants born at <26 completed weeks' gestation who require emergency laparotomy, and review the surgical pathology, incidence of subsequent surgical procedures and outcome. DESIGN: Retrospective cohort review. SETTING: Tertiary neonatal surgical unit. PATIENTS: All infants born at <26 weeks' gestation in a neonatal network over an 8-year period. RESULTS: Of 381 infants, laparotomy was indicated in 61 (16%) and performed in 57...
May 3, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28399954/using-benchmarking-to-identify-inter-centre-differences-in-persistent-ductus-arteriosus-treatment-can-we-improve-outcome
#20
Esther J S Jansen, Koen P Dijkman, Richard A van Lingen, Willem B de Vries, Daniel C Vijlbrief, Willem P de Boode, Peter Andriessen
OBJECTIVE: The aim of this study was to identify inter-centre differences in persistent ductus arteriosus treatment and their related outcomes. Materials and methods We carried out a retrospective, multicentre study including infants between 24+0 and 27+6 weeks of gestation in the period between 2010 and 2011. In all centres, echocardiography was used as the standard procedure to diagnose a patent ductus arteriosus and to document ductal closure. RESULTS: In total, 367 preterm infants were included...
April 12, 2017: Cardiology in the Young
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