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Pda treatment and preterm

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https://www.readbyqxmd.com/read/29785059/early-nt-probnp-levels-as-a-screening-tool-for-the-detection-of-hemodynamically-significant-patent-ductus-arteriosus-during-the-first-week-of-life-in-very-low-birth-weight-infants
#1
Silvia Rodriguez-Blanco, Ignacio Oulego-Erroz, Sandra Gautreaux-Minaya, Alejandro Perez-Muñuzuri, Maria Luz Couce-Pico
OBJECTIVE: To assess whether early NT-ProBNP can identify the need for echocardiographic assessment of hemodynamically significant patent ductus arteriosus (HsPDA) in preterm infants. STUDY DESIGN: Prospective observational study of infants with a gestational age ≤32 weeks. Echocardiographic assessment and NT-proBNP measurement were performed at 48-96 h. ROC curves were generated to assess optimal cutoffs to detect HsPDA and predict the need for treatment. RESULTS: Eighty-five patients were included...
May 22, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29695206/efficacy-and-safety-of-oral-paracetamol-versus-oral-ibuprofen-for-closure-of-patent-ductus-arteriosus-in-preterm-infants-a-randomized-controlled-trial
#2
Rania A El-Farrash, Mohammed S El Shimy, Abeer S El-Sakka, Manal G Ahmed, Dina G Abdel-Moez
OBJECTIVE: To evaluate the efficacy and safety of oral paracetamol versus oral ibuprofen in the treatment of hemodynamically significant patent ductus arteriosus (hsPDA) in preterm infants. STUDY DESIGN: An interventional randomized case-control study, registered in ClinicalTrials.gov ( NCT03265782 ), was conducted on 60 preterm infants with gestational age ≤ 34 weeks, postnatal age of 2-7 days and color Doppler echocardiographic evidence of hsPDA. Neonates were randomly assigned to two groups; 30 received oral ibuprofen and 30 received oral paracetamol...
April 25, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29666203/efficacy-and-safety-of-pulmonary-application-of-corticosteroids-in-preterm-infants-with-respiratory-distress-syndrome-a-systematic-review-and-meta-analysis
#3
Mahin Delara, Bhupendrasinh F Chauhan, Mê-Linh Le, Ahmed M Abou-Setta, Ryan Zarychanski, Geert W 'tJong
BACKGROUND: Systemic corticosteroids as the frontline treatment of respiratory distress syndrome (RDS) in preterm infants are associated with adverse effects on growth and neurodevelopmental outcome, but the pulmonary administration of steroids may help prevent the development of bronchopulmonary dysplasia (BPD) without these side effects. OBJECTIVES: To evaluate the efficacy and safety of pulmonary application of corticosteroids in preterm infants with RDS. METHODS: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, ClinicalTrials...
April 17, 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29663524/early-echocardiography-does-not-predict-subsequent-treatment-of-symptomatic-pda-in-extremely-preterm-infants
#4
Sujith S Pereira, Stephen T Kempley, Divyen K Shah, Joan K Morris, Ajay K Sinha
AIM: To determine whether early echocardiographic ductal parameters identified infants who subsequently received medical or surgical treatment of the patent ductus arteriosus (PDA). METHODS: Infants <29 weeks had PDA size in 2-D and colour, flow velocity and patterns obtained on day 1 and 3. Infants were followed up to identify those subsequently receiving treatment for symptomatic PDA by clinicians who were unaware of scan results. Receiver operator characteristics curves and logistic regression were performed...
April 16, 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29658447/-treatment-and-prognosis-of-pulmonary-hemorrhage-in-preterm-infants-during-2007-2016
#5
Wei-Wei Pan, Xiao-Mei Tong
OBJECTIVE: To study the treatment and prognosis of pulmonary hemorrhage in preterm infants. METHODS: A total of 106 preterm infants diagnosed with pulmonary hemorrhage, who were hospitalized in the neonatal ward of Peking University Third Hospital between 2007 and 2016, were enrolled. These patients were divided into 2007-2011 group (34 cases) and 2012-2016 group (72 cases) according to the time of hospitalization, divided into conventional-frequency ventilation group (43 cases) and high-frequency oscillatory ventilation (HFOV) group (63 cases) according to the respiratory support method used after the development of pulmonary hemorrhage, and divided into non-operation group (34 cases) and operation group (14 cases) according to whether PDA ligation was performed for the unclosed PDA before pulmonary hemorrhage...
April 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/29624206/paracetamol-acetaminophen-for-patent-ductus-arteriosus-in-preterm-or-low-birth-weight-infants
#6
REVIEW
Arne Ohlsson, Prakeshkumar S Shah
BACKGROUND: In preterm newborns, the ductus arteriosus frequently fails to close and the infants require medical or surgical closure of the patent ductus arteriosus (PDA). A PDA can be treated surgically; or medically with one of two prostaglandin inhibitors, indomethacin or ibuprofen. Case reports suggest that paracetamol may be an alternative for the closure of a PDA. An association between prenatal or postnatal exposure to paracetamol and later development of autism or autism spectrum disorder has been reported...
April 6, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29604124/risk-factors-and-mortality-rate-in-premature-babies-with-acute-kidney-injury
#7
Ahmet Taner Elmas, Yılmaz Tabel, Ramazan Özdemir
BACKGROUND: Acute kidney injury (AKI) is a common morbidity in neonatal intensive care units and associated with poor outcome. This study aimed to determine the prevalence of AKI and provide a demographic data and risk factors associated with the mortality and morbidity. METHODS: This is a retrospective study included 105 premature babies. Diagnosis of AKI was based on neonatal KDIGO classification criteria. The babies were stratified into two groups according to AKI status during the hospitalization...
March 31, 2018: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/29584842/association-of-placebo-indomethacin-ibuprofen-and-acetaminophen-with-closure-of-hemodynamically-significant-patent-ductus-arteriosus-in-preterm-infants-a-systematic-review-and-meta-analysis
#8
REVIEW
Souvik Mitra, Ivan D Florez, Maria E Tamayo, Lawrence Mbuagbaw, Thuva Vanniyasingam, Areti Angeliki Veroniki, Adriana M Zea, Yuan Zhang, Behnam Sadeghirad, Lehana Thabane
Importance: Despite increasing emphasis on conservative management of patent ductus arteriosus (PDA) in preterm infants, different pharmacotherapeutic interventions are used to treat those developing a hemodynamically significant PDA. Objectives: To estimate the relative likelihood of hemodynamically significant PDA closure with common pharmacotherapeutic interventions and to compare adverse event rates. Data Sources and Study Selection: The databases of MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched from inception until August 15, 2015, and updated on December 31, 2017, along with conference proceedings up to December 2017...
March 27, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29571706/prophylactic-and-early-targeted-treatment-of-patent-ductus-arteriosus
#9
REVIEW
Jonathan P Wyllie, Samir Gupta
Treatment of a haemodynamically significant patent ductus arteriosus (PDA) in the very preterm infant has been an accepted approach for several decades. However, the rationale for closure of PDA has recently been challenged due to reports of success with conservative approaches and the lack of evidence for longer-term benefits from treatment. In this article, we address an approach to assess treatment of those babies most likely to benefit.
March 7, 2018: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29564323/association-between-platelet-counts-before-and-during-pharmacological-therapy-for-patent-ductus-arteriosus-and-treatment-failure-in-preterm-infants
#10
Hannes Sallmon, Sven C Weber, Juliane Dirks, Tamara Schiffer, Tamara Klippstein, Anja Stein, Ursula Felderhoff-Müser, Boris Metze, Georg Hansmann, Christoph Bührer, Malte Cremer, Petra Koehne
Background: The role of platelets for mediating closure of the ductus arteriosus in human preterm infants is controversial. Especially, the effect of low platelet counts on pharmacological treatment failure is still unclear. Methods: In this retrospective study of 471 preterm infants [<1,500 g birth weight (BW)], who were treated for a patent ductus arteriosus (PDA) with indomethacin or ibuprofen, we investigated whether platelet counts before or during pharmacological treatment had an impact on the successful closure of a hemodynamically significant PDA...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29551482/role-of-neonatologist-performed-echocardiography-in-the-assessment-and-management-of-patent-ductus-arteriosus-physiology-in-the-newborn
#11
REVIEW
W P de Boode, M Kluckow, P J McNamara, S Gupta
Neonatologist-performed echocardiography (NPE) is an indispensable tool in the haemodynamic management of critically ill newborn infants. NPE is used to facilitate timely diagnosis of a patent ductus arteriosus (PDA) in preterm infants and to assess its haemodynamic significance. Before treatment is considered, it is obligatory to confirm structural cardiac normality. Importantly, NPE offers the ability to guide therapeutic interventions, allowing an individualised haemodynamic management approach to the PDA...
March 7, 2018: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29531394/effectiveness-of-injectable-ibuprofen-salts-and-indomethacin-to-treat-patent-ductus-arteriosus-in-preterm-infants-observational-cohort-study
#12
Deonne Dersch-Mills, Belal Alshaikh, Amuchou S Soraisham, Albert Akierman, Kamran Yusuf
Background: There is no injectable ibuprofen product marketed to treat patent ductus arteriosus (PDA) in newborns in Canada. The authors' institution has used ibuprofen arginine in the past. In the absence of published evidence supporting use of this salt form of ibuprofen for neonatal PDA, a retrospective analysis was undertaken. Objective: To compare the effectiveness and adverse effects of ibuprofen arginine, ibuprofen tromethamine, and indomethacin in the treatment of PDA...
January 2018: Canadian Journal of Hospital Pharmacy
https://www.readbyqxmd.com/read/29510900/genetics-of-the-patent-ductus-arteriosus-pda-and-pharmacogenetics-of-pda-treatment
#13
REVIEW
Tamorah R Lewis, Elaine L Shelton, Sara L Van Driest, Prince J Kannankeril, Jeff Reese
Patent ductus arteriosus (PDA) is a frequent, complex, and difficult to treat clinical syndrome among preterm infants in the neonatal intensive care unit. In addition to known clinical risk factors, there are emerging data about genetic predisposition to PDA in both animal and human models. Clinical response and toxicity from drugs used to treat PDA are highly variable. Developmental and genetic aspects of pharmacokinetics and pharmacodynamics influence exposure and response to pharmacologic therapies. Given the variable efficacy and toxicity of known drug therapies, novel therapeutic targets for PDA treatment offer the promise of precision medicine...
February 24, 2018: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29492399/efficacy-of-paracetamol-in-closure-of-ductus-arteriosus-in-infants-under-32-weeks-of-gestation
#14
Ines Tofe, Maria Dolores Ruiz-González, Maria Dolores Cañete, Asuncion Pino, Rosa Lorena Rueda, Maria Jose Parraga, Juan Luis Perez-Navero
Background: Standard medical treatment for patent ductus arteriosus (PDA) closure has been indomethacin/ibuprofen or surgical ligation. Up to date, new strategies have been reported with paracetamol. The aim of this study was to present our experience with intravenous paracetamol for closing PDA in preterm neonates presenting contraindication to ibuprofen or ibuprofen had failed and no candidates for surgical ligation because of huge instability. Materials and methods: We conducted a retrospective case series study in a neonatal intensive care unit from a tertiary hospital...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29468349/prediction-of-therapeutic-response-to-cyclooxygenase-inhibitors-in-preterm-infants-with-patent-ductus-arteriosus
#15
REVIEW
Yang Hu, Hongfang Jin, Yi Jiang, Junbao Du
Patent ductus arteriosus (PDA) is a morbid condition commonly seen in premature infants. Cyclooxygenase (COX) inhibitors, such as indomethacin and ibuprofen, are often used for the treatment of PDA in preterm infants, and they work by reducing the production of prostaglandin. However, as observed in clinical practice, not all PDAs in preterm infants can be closed using COX inhibitors. Some studies have demonstrated that gestational age, birth weight, B-type natriuretic peptide (BNP), and ductal diameter can predict the therapeutic responsiveness to COX inhibitors...
April 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29452581/prospective-observational-study-on-assessing-the-hemodynamic-relevance-of-patent-ductus-arteriosus-with-frequency-domain-near-infrared-spectroscopy
#16
Christoph E Schwarz, Antonio Preusche, Martin Wolf, Christian F Poets, Axel R Franz
BACKGROUND: What constitutes a hemodynamically relevant patent ductus arteriosus (hrPDA) in preterm infants is unclear. Different clinical and echocardiographic parameters are used, but a gold standard definition is lacking. Our objective was to evaluate associations between regional cerebral tissue oxygen saturation (rcStO2 ), fraction of tissue oxygen extraction (rcFtO2 E) measured by frequency domain near-infrared spectroscopy (fd-NIRS) and their correlation to echocardiographic, Doppler-ultrasound, and clinical parameters in preterm infants with and without a hrPDA...
February 16, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29372379/effect-on-cerebral-oxygenation-of-paracetamol-for-patent-ductus-arteriosus-in-preterm-infants
#17
Carlo Dani, Chiara Poggi, Ilaria Cianchi, Iuri Corsini, Venturella Vangi, Simone Pratesi
Paracetamol seems to have similar success rates compared with indomethacin and ibuprofen in closing patent ductus arteriosus (PDA) in preterm infants, but with a better safety profile. The aim of our study was to evaluate the possible effects of paracetamol on cerebral oxygenation and cerebral blood flow velocity (CBFV). Infants with gestational age < 32 weeks with hemodynamically significant PDA (hsPDA) were prospectively studied by near infrared spectroscopy (NIRS) after the first dose of paracetamol (15 mg/kg) or ibuprofen (10 mg/kg)...
April 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29333220/outcomes-of-left-ventricular-function-according-to-treatment-response-for-a-patent-ductus-arteriosus-in-preterm-infants
#18
Soo Jung Kang, Young Sun Cho, Seo Jung Hwang, Hyo Jin Kim
Background: To evaluate the outcomes of left ventricular (LV) function according to treatment response for a hemodynamically significant patent ductus arteriosus (hsPDA) in preterm infants. Methods: Echocardiograms of 21 preterm infants born at gestational age < 31 weeks obtained at term-equivalent age were retrospectively studied. Among preterm infants with a hsPDA, 9 underwent ligation after failure of pharmacological closure (ligation group) and 6 experienced successful pharmacological closure (medication group)...
December 2017: Journal of Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/29261723/shifting-the-boundaries-for-early-caffeine-initiation-in-neonatal-practice-results-of-a-prospective-multicenter-study-on-very-preterm-infants-with-respiratory-distress-syndrome
#19
MULTICENTER STUDY
Maria Katarzyna Borszewska-Kornacka, Roman Hożejowski, Magdalena Rutkowska, Ryszard Lauterbach
BACKGROUND: There is growing evidence that supports the benefits of early use of caffeine in preterm neonates with RDS; however, no formal recommendations specifying the exact timing of therapy initiation have been provided. OBJECTIVES: We compared neonatal outcomes in infants receiving early (initial dose on the 1st day of life) and late (initial dose on day 2+ of life) caffeine therapy. METHODS: Using data from a prospective, cohort study, we identified 986 infants ≤32 weeks' gestation with RDS and assessed the timing of caffeine therapy initiation, need for ventilatory support, mortality and incidence of typical complications of prematurity...
2017: PloS One
https://www.readbyqxmd.com/read/29222766/electrical-velocimetry-for-non-invasive-monitoring-of-the-closure-of-the-ductus-arteriosus-in-preterm-infants
#20
Ana Rodríguez Sánchez de la Blanca, M Sánchez Luna, N González Pacheco, M Arriaga Redondo, N Navarro Patiño
Closure of a patent ductus arteriosus (PDA) in preterm infants modifies cardiac output and induces adaptive changes in the hemodynamic situation. The present study aims to analyze those changes, through a non-invasive cardiac output monitor based on blood electrical velocimetry, in preterm babies. A prospective observational study of preterm infants with a gestational age of less than 28 weeks, and a hemodynamic significant PDA, requires intravenous ibuprofen or surgical closure. All patients were monitored with electrical velocimetry before treatment and through the following 72 h...
February 2018: European Journal of Pediatrics
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