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https://www.readbyqxmd.com/read/29730050/hemodynamic-assessment-of-the-patent-ductus-arteriosus-beyond-ultrasound
#1
REVIEW
M Kluckow, P Lemmers
Assessment and management of a patent ductus arteriosus (PDA) in premature infants remains problematic. The more immature the infant, the more likely a PDA is to be present, due to lower spontaneous PDA closure rates. Clinicians now recognize that not all PDAs require treatment and that selection of the group of infants with a more hemodynamically relevant PDA, often manifesting as an increasing systemic-to-pulmonary shunt, is increasingly important. Ultrasound is the mainstay of diagnosis and physiological assessment of the PDA; however, there are other methodologies used to assess hemodynamic importance of the PDA...
April 27, 2018: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29663524/early-echocardiography-does-not-predict-subsequent-treatment-of-symptomatic-pda-in-extremely-preterm-infants
#2
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/29695206/efficacy-and-safety-of-oral-paracetamol-versus-oral-ibuprofen-for-closure-of-patent-ductus-arteriosus-in-preterm-infants-a-randomized-controlled-trial
#3
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/29624206/paracetamol-acetaminophen-for-patent-ductus-arteriosus-in-preterm-or-low-birth-weight-infants
#4
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/29580939/non-pharmacological-management-of-a-hemodynamically-significant-patent-ductus-arteriosus
#5
A Smith, P J McNamara, A F El-Khuffash
The association between the patent ductus arteriosus (PDA) and neonatal morbidity, mortality and poor neurodevelopmental outcome in later childhood has been the focus of intense debate for decades. The lack of evidence supporting therapeutic strategies aimed at achieving PDA closure has led to the widespread adoption of conservative management aimed at mitigating the impact of shunt volume without achieving ductal closure. In this article, we review this management approach, describe the supportive evidence and potential complications associated with this strategy...
March 16, 2018: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29602579/continued-uncertainty-regarding-treatment-of-patent-ductus-arteriosus-in-premature-infants-and-the-role-of-clinical-trials
#6
REVIEW
Edmund Juszczak, Samir Gupta
Despite several decades of research into treatments for patent ductus arteriosus (PDA), there is continued uncertainty regarding whether, when, and how best to treat PDA and the long-term consequences. There are almost 5000 babies enrolled into clinical trials, but the questions remain largely unanswered. Many of the trials performed over the period were well designed and addressed important clinical questions, but the results are not necessarily directly applicable to the clinical management dilemmas of today since perinatal care has improved over time per se, the patient population is typically more premature, and there have been technological advances in diagnosis...
March 7, 2018: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29468349/prediction-of-therapeutic-response-to-cyclooxygenase-inhibitors-in-preterm-infants-with-patent-ductus-arteriosus
#7
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/29343586/a-case-of-cardiomyopathy-due-to-premature-ductus-arteriosus-closure-the-flip-side-of-paracetamol
#8
Ingrid Anne Mandy Schierz, Mario Giuffrè, Ettore Piro, Simona La Placa, Giovanni Corsello
Paracetamol (acetaminophen or N-acetyl-p-aminophenol) is considered a safe analgesic and antipyretic nonsteroidal antiinflammatory drug commonly used during pediatric ages and during pregnancy. We report on a term neonate with closed ductus arteriosus, severe cardiomyopathy, right ventricular dysfunction, and functional stenosis of pulmonary arteries at birth after maternal self-medication with paracetamol and consumption of polyphenol-rich foods in late pregnancy. This drug, especially when associated with other vasoconstrictors (such as polyphenols), interferes with prostaglandin metabolism, which seriously accentuates the intrauterine ductus arteriosus constriction and leads to pharmacologic adverse events...
February 2018: Pediatrics
https://www.readbyqxmd.com/read/29306492/outcomes-of-surgical-ligation-after-unsuccessful-pharmacotherapy-for-patent-ductus-arteriosus-in-neonates-born-extremely-preterm
#9
Dany E Weisz, Lucia Mirea, Maura H F Resende, Linh Ly, Paige T Church, Edmond Kelly, S Joseph Kim, Amish Jain, Patrick J McNamara, Prakesh S Shah
A retrospective cohort study of neonates born extremely preterm with persistent patent ductus arteriosus after unsuccessful pharmacologic closure compared outcomes between 166 surgically ligated and 142 nonligated neonates. After adjustment for confounders, ligation was not associated with the composite outcome of death or neurodevelopmental impairment, neurodevelopmental impairment alone, chronic lung disease, or retinopathy of prematurity among survivors.
April 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29105147/intravenous-paracetamol-was-associated-with-closure-of-the-ductus-arteriosus-in-extremely-premature-infants
#10
S Juujärvi, T Saarela, M Hallman, O Aikio
AIM: Symptomatic patent ductus arteriosus may lead to serious complications in extremely preterm and extremely low birthweight infants and is often resistant to medication. We evaluated early intravenous paracetamol for pain prevention during respiratory therapy, in an attempt to understand the ductal treatment of such infants. METHODS: Our cohort were 295 extremely preterm or extremely low birthweight infants, born at less than 28 weeks or 1000 g, respectively, who were treated in the neonatal intensive care unit of Oulu University Hospital from 2002 to 2015, before and after intravenous paracetamol was introduced in June 2009...
April 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29119215/surgical-ligation-versus-percutaneous-closure-of-patent-ductus-arteriosus-in-very-low-weight-preterm-infants-which-are-the-real-benefits-of-the-percutaneous-approach
#11
A Rodríguez Ogando, I Planelles Asensio, A Rodríguez Sánchez de la Blanca, F Ballesteros Tejerizo, M Sánchez Luna, J M Gil Jaurena, C Medrano López, J L Zunzunegui Martínez
Percutaneous treatment of patent ductus arteriosus (PDA) in extreme premature infants is technically difficult, and therefore, often not consider as an alternative to surgery. The main objective of our work was to compare respiratory status prior and post ductal closure and morbi-mortality, in our series of preterm infants with percutaneous PDA closure versus surgical ligation in the same time-period. Retrospective review of all premature infants submitted to percutaneous and surgical PDA closure from January 2011 to December 2016...
February 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29043398/oral-paracetamol-for-patent-ductus-arteriosus-rescue-closure
#12
Pramod Pharande, Hadley Watson, Kenneth Tan, Arvind Sehgal
The objective of this study was to ascertain the efficacy of oral paracetamol in closing a symptomatic patent ductus arteriosus (PDA) when used as 'rescue' option. After obtaining ethics approval, a retrospective appraisal of the data from April 2014 to July 2015 was performed. Infants who were administered oral paracetamol either after unsuccessful therapy with ibuprofen or where it was considered contraindicated were included. A previously published echocardiographic scoring schema to stratify for ductal disease severity was used...
January 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/28680875/echocardiographic-evaluation-of-patent-ductus-arteriosus-in-preterm-infants
#13
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/28625190/association-between-early-echocardiography-therapy-for-patent-ductus-arteriosus-and-outcomes-in-very-low-birth-weight-infants
#14
Jan Hau Lee, Rachel G Greenberg, Bin H Quek, Reese H Clark, Matthew M Laughon, P Brian Smith, Christoph P Hornik
BACKGROUND: In very low birth weight infants, persistence of a patent ductus arteriosus results in morbidity and mortality. Therapies to close the ductus are effective, but clinical outcomes may depend on the accuracy of diagnosis and the timing of administration. The objective of the present study was to characterise the association between early echocardiography, therapy for patent ductus arteriosus, and outcomes in very low birth weight infants. METHODS: This retrospective cohort study used electronic health record data on inborn infants of gestational age ⩽28 weeks and birth weight <1500 g who were discharged after day of life 7 from 362 neonatal ICU from 1997 to 2013...
November 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28617424/outcomes-following-indomethacin-prophylaxis-in-extremely-preterm-infants-in-an-all-referral-nicu
#15
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)...
August 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28396025/prophylactic-indomethacin-compared-with-delayed-conservative-management-of-the-patent-ductus-arteriosus-in-extremely-preterm-infants-effects-on-neonatal-outcomes
#16
Melissa Liebowitz, Ronald I Clyman
OBJECTIVE: To determine whether prophylactic indomethacin (PINDO) has more or less morbidity than delayed conservative management of the moderate-to-large patent ductus arteriosus (PDA). STUDY DESIGN: We performed a prospective double cohort controlled study of infants delivered at ≤276/7 weeks gestation (n = 397). From January 2005 through April 2011, all infants were treated with PINDO (n = 247). From May 2011 through August 2016, no infant was treated with indomethacin until at least 8 postnatal days (conservative epoch, n = 150)...
August 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28395364/neurodevelopmental-outcomes-of-preterm-infants-treated-with-oral-paracetamol-versus-ibuprofen-for-patent-ductus-arteriosus
#17
Mehmet Yekta Oncel, Zeynep Eras, Nurdan Uras, Fuat Emre Canpolat, Omer Erdeve, Serife Suna Oguz
Objective  This study aims to determine the effects of paracetamol versus ibuprofen treatment given to preterm infants for the pharmacological closure of patent ductus arteriosus (PDA) on neurodevelopmental outcomes at 18 to 24 months' corrected age. Method  A follow-up study was conducted to evaluate the neurodevelopmental outcomes of preterm infants (gestational age ≤ 30 weeks) enrolled in a randomized controlled trial comparing oral paracetamol versus oral ibuprofen for the closure of PDA. The developmental assessment was done by using "Bayley Scales of Infant Development, Second Edition" at 18 to 24 months' corrected age...
October 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28206995/patent-ductus-arteriosus-in-premature-infants-to-treat-or-not-to-treat
#18
M A Mohamed, M El-Dib, S Alqahtani, K Alyami, A N Ibrahim, H Aly
OBJECTIVE: Closing patent ductus arteriosus (PDA) is a widely accepted approach in the management of very low birth weight (VLBW) infants. Our objective is to test the hypothesis that conservative management (no treatment) of PDA will not affect survival without chronic lung diseases (CLD). STUDY DESIGN: This retrospective study utilizes a prospectively collected database to compare two cohorts of VLBW infants. Infants in the first group (2001 to 2009) had their PDA treated with pharmacological and if necessary with surgical ligation...
June 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28139441/normative-values-of-aortic-arch-structures-in-premature-infants
#19
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/28185778/efficacy-of-repeated-courses-of-ibuprofen-in-the-closure-of-patent-ductus-arteriosus-in-premature-infants
#20
EDITORIAL
Ting-An Yen, Ching-Chia Wang
No abstract text is available yet for this article.
February 2017: Pediatrics and Neonatology
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