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https://www.readbyqxmd.com/read/29343586/a-case-of-cardiomyopathy-due-to-premature-ductus-arteriosus-closure-the-flip-side-of-paracetamol
#1
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/29372379/effect-on-cerebral-oxygenation-of-paracetamol-for-patent-ductus-arteriosus-in-preterm-infants
#2
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)...
January 25, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29203106/oral-pharmacological-treatment-for-patent-ductus-arteriosus-in-premature-neonates-with-hemodynamic-repercussions
#3
Clarissa de Albuquerque Botura, Bruno Ambrósio da Rocha, Thiely Balensiefer, Franciele Queiroz Ames, Ciomar Aparecida Bersani-Amado, Roberto Kenji Nakamura Cuman
OBJECTIVE: To evaluate the efficacy of oral indomethacin, ibuprofen, and paracetamol in oral dosage form on patent ductus arteriosus (PDA) in premature neonates with significant clinical and hemodynamic repercussions (CHRs) and to determine the effect of these respective treatments on renal function. METHODS: A retrospective study of cases of PDA in premature neonates in the Neonatal Intensive Care Unit was conducted. The treatments consisted of indomethacin [0...
November 2017: Asian Pacific Journal of Tropical Medicine
https://www.readbyqxmd.com/read/29290747/acetaminophen-for-patent-ductus-arteriosus-in-extremely-low-birth-weight-neonates
#4
Caitlyn M Luecke, Caren J Liviskie, Brandy N Zeller, Zachary A Vesoulis, Christopher McPherson
OBJECTIVE: Although non-steroidal anti-inflammatory drugs (NSAIDs) are the current standard therapy for the treatment of patent ductus arteriosus (PDA), many neonates have contraindications to receiving or may fail NSAID therapy. To avoid surgical ligation, these patients may benefit from an alternative therapy. The objective of this research is to report the efficacy and safety of acetaminophen for the treatment of PDA in a cohort of premature neonates. METHODS: Demographics and clinical course were retrospectively evaluated for all neonates admitted during the study period who received acetaminophen for the treatment of PDA...
November 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29258124/nonsurgical-management-of-persistent-and-hemodynamically-significant-patent-ductus-arteriosus-among-extremely-low-birth-weight-infants-a-propensity-score-matched-analysis
#5
Ramachandra Bhat, Kalsang Dolma, Michael Zayek, Lynn Batten, Keith Peevy, Fabien Eyal
OBJECTIVE:  The objective of this study was to evaluate the impact of a nonsurgical approach (with the incorporation of late postnatal hydrocortisone treatment to facilitate extubation) in comparison to the surgical approach for the management of persistent hemodynamically significant patent ductus arteriosus (hsPDA) among chronically ventilator-dependent extremely low birth weight (ELBW) infants. METHODS:  In this retrospective study, ELBW infants with a diagnosis of hsPDA (diagnosed based on the echocardiographic criteria and chronic ventilator dependence) that were persistent beyond 14 days of postnatal age despite adequate medical treatment were included...
December 19, 2017: American Journal of Perinatology
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
#6
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/29105147/intravenous-paracetamol-was-associated-with-closure-of-the-ductus-arteriosus-in-extremely-premature-infants
#7
S Juujärvi, T Saarela, M Hallman, O Aikio
AIM: Symptomatic patent ductus arteriosus may lead to serious complications in extremely preterm and extremely low birth weight 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 birth weight infants, born at less than 28 weeks or 1,000g, respectively, who were treated in the neonatal intensive care unit of Oulu University Hospital from 2002-2015, before and after intravenous paracetamol was introduced in June 2009...
November 4, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/29066474/transcatheter-occlusion-of-the-patent-ductus-arteriosus-in-premature-infants-weighing-less-than-1200-g
#8
Patrice Morville, Stephanie Douchin, Helene Bouvaist, Claire Dauphin
OBJECTIVES: Over the last few decades different strategies have been proposed to treat persistent ductal patency in premature infants. The advent of the Amplatzer Duct Occluder II Additional Size (ADOIIAS) provided the potential to close the patent ductus arteriosus (PDA). Opinions differ on the significance and treatment of PDA in premature neonates. Because surgical ligation and medical therapy both have their drawbacks, interventional catheterisation can be considered as an alternative means of closing the ductus arteriosus...
October 24, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29043398/oral-paracetamol-for-patent-ductus-arteriosus-rescue-closure
#9
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/28847349/patent-ductus-arteriosus-in-preterm-infants-part-1-understanding-the-pathophysiologic-link-between-the-patent-ductus-arteriosus-and-clinical-complications
#10
Yasser N Elsayed, Debbie Fraser
The clinical guidelines for treating patent ductus arteriosus (PDA) have significantly evolved over the last decades from treating any ductal shunt to more conservative management where only the hemodynamically significant patent ductus arteriosus (HSPDA) is treated. This shift has resulted largely from a lack of evidence from randomized controlled trials supporting a relationship between treating a PDA and improving long-term neonatal outcomes. However, there are many unresolved issues. There is no consensus on the precise definition of HSPDA requiring treatment or a clear understanding of when to treat HSPDA...
September 1, 2017: Neonatal Network: NN
https://www.readbyqxmd.com/read/28625190/association-between-early-echocardiography-therapy-for-patent-ductus-arteriosus-and-outcomes-in-very-low-birth-weight-infants
#11
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/28701390/spontaneous-closure-of-patent-ductus-arteriosus-in-infants-%C3%A2-1500-g
#12
COMPARATIVE STUDY
Jana Semberova, Jan Sirc, Jan Miletin, Jachym Kucera, Ivan Berka, Sylva Sebkova, Sinead O'Sullivan, Orla Franklin, Zbynek Stranak
OBJECTIVES: Patent ductus arteriosus (PDA) remains a challenging issue in very low birth weight (VLBW) infants, and its management varies widely. Our aim in this study was to document the natural course of ductus arteriosus in a cohort of VLBW infants who underwent conservative PDA management with no medical or surgical intervention. METHODS: A retrospective cohort study conducted in 2 European level-3 neonatal units. RESULTS: A total of 368 VLBW infants were born within the study period...
August 2017: Pediatrics
https://www.readbyqxmd.com/read/27522442/elevated-nucleated-red-blood-cells-at-birth-predict-hemodynamically-significant-patent-ductus-arteriosus
#13
Alona Bin-Nun, Francis B Mimouni, Daniel Fink, Hen Sela, Cathy Hammerman
We hypothesized that postnatal absolute nucleated red blood cell (aNRBC) counts would be elevated in premature infants with hemodynamically significant patent ductus arteriosus (PDA), reflecting intrauterine hypoxia. PDA severity was assessed and categorized echocardiographically. aNRBC counts were significantly correlated with ductal severity (Pearson correlation: P = .007). At the extremes, aNRBC levels were 3770 (728, 6015) hemodynamically significant PDA vs 865 (483, 2528) closed ductus.
October 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/28562302/trends-in-patent-ductus-arteriosus-diagnosis-and-management-for-very-low-birth-weight-infants
#14
Samantha Ngo, Jochen Profit, Jeffrey B Gould, Henry C Lee
OBJECTIVE: To examine yearly trends of patent ductus arteriosus (PDA) diagnosis and treatment in very low birth weight infants. METHODS: In this retrospective cohort study of very low birth weight infants (<1500 g) between 2008 and 2014 across 134 California hospitals, we evaluated PDA diagnosis and treatment by year of birth. Infants were either inborn or transferred in within 2 days after delivery and had no congenital abnormalities. Intervention levels for treatment administered to achieve ductal closure were categorized as none, pharmacologic (indomethacin or ibuprofen), both pharmacologic intervention and surgical ligation, or ligation only...
April 2017: Pediatrics
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/28724506/the-use-of-non-steroidal-anti-inflammatory-drugs-for-patent-ductus-arteriosus-closure-in-preterm-infants
#16
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...
October 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28680875/echocardiographic-evaluation-of-patent-ductus-arteriosus-in-preterm-infants
#17
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/28720053/paracetamol-versus-ibuprofen-for-the-treatment-of-patent-ductus-arteriosus-in-preterm-neonates-a-meta-analysis-of-randomized-controlled-trials
#18
Xintao Huang, Fang Wang, Kai Wang
BACKGROUND: Paracetamol has been suggested as an effective treatment for patent ductus arteriosus (PDA). However, the comparative efficacy and safety between paracetamol and ibuprofen were not determined. METHODS: A meta-analysis of randomized controlled trials (RCTs) was performed. Relevant studies were identified via database searching. A fixed or random effect model was applied depending on the extent of heterogeneity. RESULTS: Five RCTs with 677 neonates were included...
July 18, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27509008/trends-and-variation-in-management-and-outcomes-of-very-low-birth-weight-infants-with-patent-ductus-arteriosus
#19
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 patent ductus arteriosus (PDA) in very-low-birth-weight (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 d between 1 January 2005 and 31 December 2014. PDA management and in-hospital outcomes were examined for trends and variation...
December 2016: Pediatric Research
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
#20
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 ≤27 6/7 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
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