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patent ductus arteriosus neonate

Alireza Sadeghnia, Behzad Koorang Beheshti, Majid Mohammadizadeh
Background: Considering all the latest achievements in neonatal respiratory care, bronchopulmonary dysplasia (BPD) is still among the most prevalent morbidity causes in premature infants. Involvement in this process results in longer period of hospitalization for the newborn and in the long run makes the living conditions more difficult. Taking the multifactorial pathogenesis into account, approaches to tackle chronic lung disease (CLD) are mainly focused on interventions and prevention procedures...
2018: International Journal of Preventive Medicine
Abdul Malik Sheikh, Abdul Karim Duke, Hina Sattar
Patent ductus arteriosus is a common congenital cardiac defect comprising 5-10% of all these defects in term neonates. Although open chest and video-assisted interruption are still in use, transcatheter occlusion has rapidly become the first choice for patent ductus arteriosus closure in the appropriate patient. Percutaneous closure of patent ductus arteriosus is widely done by transvenous approach guided by aortic access. We present the case of a 2 year old girl who underwent patent ductus arteriosus device occlusion with transvenous access only...
March 2018: JPMA. the Journal of the Pakistan Medical Association
Arvind Sehgal, Patrick J McNamara
Whereas association between a patent ductus arteriosus (PDA) and neonatal morbidities has been well described, consensus has not been reached on whether the relationship is causal, on benefit of (or lack of) treatment, on factors guiding the 'need to treat', and on treatment strategies. Trials to date have primarily focused on the narrow outcome of successful ductal closure. Evidence from several retrospective studies has suggested that management may be modified with increased use of conservative treatment...
March 7, 2018: Seminars in Fetal & Neonatal Medicine
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
Patricio E Lau, Stephanie M Cruz, Elena C Ocampo, Sushma Nuthakki, Candace C Style, Timothy C Lee, David E Wesson, Oluyinka O Olutoye
PURPOSE: The purpose of this study was to evaluate the characteristics of patients with congenital heart disease (CHD) who developed necrotizing enterocolitis (NEC). METHODS: A retrospective review of neonates with CHD at a tertiary care center between January 2006 and January 2016 was performed. Diagnosis of NEC was based on modified Bell's criteria. Patients were grouped by Risk Adjustment for Congenital Heart Surgery (RACHS-1) or by ductal-dependent (DD) lesions that require a patent ductus arteriosus to supply pulmonary or systemic circulation...
February 7, 2018: Journal of Pediatric Surgery
Alona Bin-Nun, Daniel Fink, Francis B Mimouni, Nurit Algur, Cathy Hammerman
We determined serum paracetamol concentrations 4 hours after the eighth dose in infants treated enterally for ductal closure. Serum paracetamol concentrations correlated (P = .0026) with ductal response. No patent ductus arteriosus in a baby with paracetamol levels <20 mg/L closed in response to treatment. Paracetamol levels also correlated (P = .046) with postnatal age.
March 7, 2018: Journal of Pediatrics
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
Biagio Castaldi, Giulia Bordin, Valentina Favero, Daniel Nardo, Francesca Previati, Sabrina Salvadori, Eugenio Baraldi, Ornella Milanesi
BACKGROUND AND AIMS: Preterm newborns undergo hemodynamic challenges in the postnatal period. The aim of this study was to investigate myocardial mechanics changes in the postnatal period in preterm infants using speckle tracking echocardiography (STE). MATERIAL AND METHODS: Thirty-nine preterm infants ≤34 weeks' gestation underwent cardiac ultrasound evaluation during the first 96 hours of life. A repeated echocardiogram at 3 weeks of age was performed. Echocardiographic assessment involved left ventricular ejection fraction, mitral E/A ratio, S' and E' velocities, E/E' ratio, tricuspid annular plane systolic excursion (TAPSE), left atrium-to-aorta ratio, ductal diameter and ductal shunt pattern...
March 6, 2018: Echocardiography
Víctor Lago Leal, Loida Pamplona Bueno, Lucía Cabanillas Vilaplana, Estefanía Nicolás Montero, Mónica Martín Blanco, Cristina Fernández Romero, Sara El Bakkali, Tamara Pradillo Aramendi, Lara Sobrino Lorenzano, Paula Castellano Esparza, Esther Ballesteros Benito, Nieves Rayo Navarro, Pablo Del Barrio Fernández, Vanesa Ocaña Martínez, Luis Martínez Cortés
OBJECTIVE: To assess the short and medium-term effects of milking maneuver (MM) compared with early cord clamping for infants born before 37 weeks of pregnancy. MATERIAL AND METHODS: 138 infants between 24+0 and 36+6 weeks of gestation were allocated to MM or early cord clamping. Primary outcomes were the requirement of red blood cell transfusions or phototherapy. RESULTS: Initial hemoglobin was significantly higher in the MM group by 1.675 g/dL (p < 0...
March 5, 2018: Fetal Diagnosis and Therapy
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
Smita Akkinapally, Shilpa G Hundalani, Madhulika Kulkarni, Caraciolo J Fernandes, Antonio G Cabrera, Binoy Shivanna, Mohan Pammi
BACKGROUND: Prostaglandin E1 (PGE1) is used to keep the ductus arteriosus patent and can be life-saving in neonates with ductal-dependent cardiac lesions. PGE1 is used to promote mixing of pulmonary and systemic blood flow or improve pulmonary or systemic circulations, prior to balloon atrial septostomy or surgery. PGE1 therapy may cause several short-term and long-term adverse effects. The efficacy and safety of PGE1 in neonates with ductal-dependent cardiac lesions has not been systematically reviewed...
February 27, 2018: Cochrane Database of Systematic Reviews
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...
February 21, 2018: Pediatric Cardiology
Vikas Yadav, J B Sharma, S Mishra, A Kriplani, Neerja Bhatla, Garima Kachhawa, Rajesh Kumari, Karthik, Isha Kriplani
OBJECTIVES: To study pregnancy outcomes in operated vs non-operated cases of congenital heart disease cases during pregnancy. MATERIALS AND METHODS: A total of 55 patients of congenital heart disease who delivered in the authors unit in last 10 years were taken in this retrospective study. These were divided into two groups Group 1:29 (52.7%) patient who had no cardiac surgery and Group 2: 26(47.2%) who had cardiac surgery to correct their cardiac defect before pregnancy...
January 2018: Indian Heart Journal
Timothy J B Ulrich, Taylor P Hansen, Kimberly J Reid, Michael A Bingler, Steven L Olsen
OBJECTIVE: The influence of post-ligation cardiac syndrome (PLCS), a complication of patent ductus arteriosus (PDA) ligations, on neonatal outcomes is unknown. The purpose of this study was to determine the risks of PLCS on severe pulmonary morbidity and severe retinopathy of prematurity (ROP). STUDY DESIGN: Retrospective cohort study of infants who underwent a PDA ligation between 2006 and 2015. Data were collected on patients with and without PLCS. The primary outcome was the difference in severe bronchopulmonary dysplasia (BPD) between groups...
February 16, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
Gerhard Pichler, Nina Höller, Nariae Baik-Schneditz, Bernhard Schwaberger, Lukas Mileder, Jasmin Stadler, Alexander Avian, Jasmin Pansy, Berndt Urlesberger
Introduction: Up to 50% of preterm infants admitted to intensive care units require cardiocirculatory support. The aim of the present study was to assess whether simultaneous monitoring of cerebral tissue oxygenation index (cTOI) and peripheral tissue oxygenation index (pTOI) using near-infrared spectroscopy (NIRS) in combination with dedicated intervention guidelines may help avoiding arterial hypotension and catecholamine administration in preterm neonates. Study design: Preterm neonates <37 weeks of gestation were included in a single center randomized controlled study...
2018: Frontiers in Pediatrics
Mousam Dey, Naveen Garg, Sunil Kumar
Interrupted aortic arch is a rare congenital anomaly in newborns and infants and is commonly associated with other cardiovascular anomalies. Here, we report an unusual case of type A interrupted cervical aortic arch associated with long segment coarctation of the descending thoracic aorta. Patent ductus arteriosus reconstituted the descending thoracic aorta. Proximal segments of the left common carotid and left subclavian arteries were atretic. Echocardiography-gated multidetector CT angiography not only identified the type of aortic arch interruption in the neonate but also delineated the exact anatomical details...
February 9, 2018: Cardiology in the Young
Lilly-Ann Mohlkert, Jenny Hallberg, Olof Broberg, Annika Rydberg, Cecilia Pegelow Halvorsen, Petru Liuba, Vineta Fellman, Magnus Domellöf, Gunnar Sjöberg, Mikael Norman
BACKGROUND: Preterm birth has been associated with increased risk of cardiovascular morbidity in adult life. We evaluated whether preterm birth is associated with deviating cardiac structure and function before school start. METHODS AND RESULTS: In total, 176 children aged 6 years and born extremely preterm (EXPT; gestational age of 22-26 weeks) and 134 children born at term (control [CTRL]) were studied. We used echocardiography to assess left heart dimensions, geometry, and functions...
January 20, 2018: Journal of the American Heart Association
Alice Héneau, Fabien Guimiot, Damir Mohamed, Aline Rideau Batista Novais, Corinne Alberti, Olivier Baud
OBJECTIVES: To investigate the relationship between histologic findings of the placenta and response to early postnatal hydrocortisone treatment used to prevent bronchopulmonary dysplasia (BPD) in extremely preterm infants. METHODS: In an exploratory analysis of the Early Low-Dose Hydrocortisone to Improve Survival Without Bronchopulmonary Dysplasia in Extremely Preterm Infants (PREMILOC) trial, detailed placental analyses were performed on the basis of standardized macroscopic and histologic examinations...
February 2018: Pediatrics
Samuel J Gentle, Colm P Travers, Waldemar A Carlo
PURPOSE OF REVIEW: Caffeine use in preterm infants has endured several paradigms: from standard of care to possible neurotoxin to one of the few medications for which there is evidence of bronchopulmonary dysplasia (BPD) risk reduction. The purpose of the review is to analyze this dynamic trajectory and discuss controversies that still remain after decades of caffeine use. RECENT FINDINGS: Following concerns for caffeine safety in preterm infants, a large randomized controlled trial demonstrated a reduction in BPD and treatment for patent ductus arteriosus...
April 2018: Current Opinion in Pediatrics
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
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