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Pda and preterm

Colm R Breatnach, Orla Franklin, Naomi McCallion, Afif El-Khuffash
Systemic hypoperfusion secondary to a patent ductus arteriosus (PDA) is thought to only affect post-ductal vessels. In a prospective observational study of 51 preterm infants, we demonstrated that a persistent PDA by day 5-7 is associated with reversed diastolic flow in the brachiocephalic artery when compared with those without a PDA.
October 18, 2016: Journal of Pediatrics
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
Monika Żurawska-Kliś, Marcin Kosiński, Ewa Wender-Ożegowska, Łukasz Bartyzel, Elżbieta Matysiak, Bogusława Olak-Białoń, Beata Królikowska-Kobierska, Iwona Towpik, Katarzyna Cypryk
OBJECTIVES: The aim of the present study was to compare the obstetric results in women with GDM in a Polish population based on the criterion for the diagnosis of GDM. MATERIAL AND METHODS: The study was a questionnaire study covering the data of 2853 patients with GDM treated in centers nationwide in the years 2011-2013. The principles of self-control, glycemic targets and treatment were based on the then-current PDA guidelines. Analysis of the collected data included an assessment of obstetric results based on the diagnostic criteria for GDM...
2016: Ginekologia Polska
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
Vinay Vamadev Kulkarni, Sourabh Dutta, Venkataseshan Sundaram, Shiv Sajan Saini
OBJECTIVES: To evaluate whether preterm thrombocytopenia within 24 hours of birth is associated with delayed closure of patent ductus arteriosus (PDA) and higher proportion of hemodynamically significant PDA (Hs-PDA). METHODS: Neonates (gestation 26(0/7)-33(6/7) weeks, age <24 hours) with known platelet count and PDA on echocardiogram were prospectively enrolled. Asphyxia, congenital infections, structural heart disease, major malformations and clinical sepsis were exclusions...
September 28, 2016: Pediatrics
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
Meryem Kurek Eken, Abdülhamit Tüten, Enis Özkaya, Güner Karatekin, Ateş Karateke
OBJECTIVE: To assess the predictors of outcome in terms of length of stay in the neonatal intensive care unit (NICU) and survival of neonates from women with preterm premature rupture of membranes (PPROM). METHODS: A population-based retrospective study including three hundred thirty-one singleton pregnant women with PPROM at 24-34 gestational weeks between January 2013 and December 2015 was conducted. Gestational age at delivery, birth weight, route of delivery, newborn gender, maternal age,oligohydramnios, premature retinopathy (ROP), necrotising enterocolitis (NEC), sepsis, fetal growth retardation (FGR), intracranial hemorrhagia (ICH), bronchopulmonary dysplasia (BPD), respiratory distress syndrome (RDS), primary pulmonary hypertension (PPH), congenital cardiac disease (CCD), patent ductus arteriosus (PDA), use of cortisol (betamethasone) and maternal complications including gestational diabetes, preeclampsia, and chorioamnionitis were used to predict neonatal outcomes in terms of length of stay in the NICU and survival...
September 14, 2016: Journal of Maternal-fetal & Neonatal Medicine
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
J Banerjee, T S Leung, N Aladangady
BACKGROUND AND OBJECTIVE: The objective of the study was to investigate the splanchnic blood flow velocity and oximetry response to blood transfusion in preterm infants according to postnatal age. MATERIALS AND METHODS: Preterm infants receiving blood transfusion were recruited to three groups: 1-7 (group 1; n = 20), 8-28 (group 2; n = 21) and ≥29 days of life (group 3; n = 18). Superior mesenteric artery (SMA) peak systolic (PSV) and diastolic velocities were measured 30-60 min pre- and post-transfusion using Doppler ultrasound scan...
August 10, 2016: Vox Sanguinis
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
Shahnaz Pourarian, Deepak Sharma, Sirous Cheriki, Farhad Bijanzadeh, Nazanin Farahbakhsh
AIMS: To evaluate the prevalence of symptomatic and non-symptomatic ductus arteriosus (PDA) and accuracy of physical signs in diagnosing PDA in preterm infants using blinded comparison of clinical and echocardiographic findings during the first week of life. METHODS AND MATERIAL: This prospective observational cross sectional study enrolled 200 preterm infants, who underwent echocardiography on 4(th) -7(th) postnatal day. The neonates who was diagnosed to have PDA on echo were observed for clinical features of PDA to label it symptomatic PDA...
August 5, 2016: Journal of Maternal-fetal & Neonatal 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
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
Mohamed M Morsy, Osama O Algrigri, Sherif S Salem, Mostafa M Abosedera, Ashraf R Abutaleb, Khaled M Al-Harbi, Ibrahim S Al-Mozainy, Abdulhameed A Alnajjar, Abdelhadi M Habeb, Hany M Abo-Haded
OBJECTIVES: To to define the frequency and patterns of congenital heart disease (CHD) among children with Down syndrome (DS) in Northwest Saudi Arabia.  METHODS: We included children with confirmed DS referred to the regional pediatric cardiology unit in Madinah Maternity and Children Hospital between January 2008 and December 2013. Children were identified from the unit's data-base and the charts were reviewed retrospectively. We excluded term and preterm children with patent ducts arteriosus (PDA) and persistent foramen oval spontaneously resolved during the first 4 weeks of life...
July 2016: Saudi Medical Journal
Shehab Ahmed Alenazi
OBJECTIVES: Evaluate the role of NT-proBNP levels in Preterm neonates suffering from PDA and used as a screening tool for predicting HsPDA and guiding physicians to consider early echocardiographic evaluation. METHODS: This is a monocentric prospective blind study which was conducted at Arar Central Hospital, Ar'ar, Saudi Arabia, during the period between Jan 2014 to June 2014. Thirty-three (33) preterm infants born at less than 31 weeks of gestation or weighing less than 1200 g at birth infants were initially enrolled during a 6-month period...
May 2016: Pakistan Journal of Medical Sciences Quarterly
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