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https://www.readbyqxmd.com/read/29043398/oral-paracetamol-for-patent-ductus-arteriosus-rescue-closure
#1
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...
October 17, 2017: 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
#2
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
#3
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...
June 19, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28701390/spontaneous-closure-of-patent-ductus-arteriosus-in-infants-%C3%A2-1500-g
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/28395364/neurodevelopmental-outcomes-of-preterm-infants-treated-with-oral-paracetamol-versus-ibuprofen-for-patent-ductus-arteriosus
#13
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
#14
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/28185778/efficacy-of-repeated-courses-of-ibuprofen-in-the-closure-of-patent-ductus-arteriosus-in-premature-infants
#15
EDITORIAL
Ting-An Yen, Ching-Chia Wang
No abstract text is available yet for this article.
February 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28125815/patent-ductus-arteriosus-treatment-in-very-preterm-infants-a-european-population-based-cohort-study-epice-on-variation-and-outcomes
#16
Anna-Karin Edstedt Bonamy, Anna Gudmundsdottir, Rolf F Maier, Liis Toome, Jennifer Zeitlin, Mercedes Bonet, Alan Fenton, Asbjørn Børch Hasselager, Arno van Heijst, Ludwig Gortner, David Milligan, Patrick Van Reempts, Elaine M Boyle, Mikael Norman
BACKGROUND: Spontaneous closure of patent ductus arteriosus (PDA) occurs frequently in very preterm infants and despite the lack of evidence for treatment benefits, treatment for PDA is common in neonatal medicine. OBJECTIVES: The aim of this work was to study regional variations in PDA treatment in very preterm infants (≤31 weeks of gestation), its relation to differences in perinatal characteristics, and associations with bronchopulmonary dysplasia (BPD) and survival without major neonatal morbidity...
2017: Neonatology
https://www.readbyqxmd.com/read/27698754/oral-paracetamol-vs-oral-ibuprofen-in-the-treatment-of-symptomatic-patent-ductus-arteriosus-in-premature-infants-a-randomized-controlled-trial
#17
Bo Yang, Xiangyu Gao, Yi Ren, Yun Wang, Qinglin Zhang
The aim of the present study was to analyze the changes of plasma and urinary prostaglandin E2 (PGE2) levels in preterm infants with symptomatic patent ductus arteriosus (sPDA) treated with oral ibuprofen and acetaminophen. A total of 87 preterm infants with sPDA admitted to the Neonatal Ward of the Affiliated Xuzhou Hospital of Medical College of Southeast University from October, 2012 to June, 2015 were selected and randomly divided into the ibuprofen group (n=43, 10 mg/kg ibuprofen administered orally as initial dose, followed by 5 mg/kg during the first 24 and 48 h later) and acetaminophen group (n=44, 15 mg/kg acetaminophen administered orally once every 6 h for three days)...
October 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28046188/comparative-effectiveness-of-nonsteroidal-anti-inflammatory-drug-treatment-vs-no-treatment-for-patent-ductus-arteriosus-in-preterm-infants
#18
Jonathan L Slaughter, Patricia B Reagan, Thomas B Newman, Mark A Klebanoff
Importance: Patent ductus arteriosus (PDA) is associated with increased mortality and worsened respiratory outcomes, including bronchopulmonary dysplasia (BPD), in preterm infants. Nonsteroidal anti-inflammatory drugs (NSAIDs) are efficacious in closing PDA, but the effectiveness of NSAID-mediated PDA closure in improving mortality and preventing BPD is unclear. Objective: To determine the effectiveness of NSAID treatment for PDA in reducing mortality and moderate/severe BPD at 36 weeks postmenstrual age...
March 6, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28041670/management-of-patent-ductus-arteriosus-are-we-looking-at-the-right-outcomes
#19
EDITORIAL
Eduardo Bancalari, Deepak Jain
No abstract text is available yet for this article.
March 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/21194597/efficacy-and-tolerability-of-enteral-formulations-of-ibuprofen-in-the-treatment-of-patent-ductus-arteriosus-in-preterm-infants
#20
REVIEW
Jean-Bernard Gouyon, Yves Kibleur
BACKGROUND: The persistence of a patent ductus arteriosus (PDA) in preterm infants complicates their clinical course and may contribute to increased morbidity. Intravenous preparations of ibuprofen constitute one of the standard therapies for closure of a PDA. However, the unavailability of intravenous ibuprofen in certain regions of the world and the availability of inexpensive oral preparations has led to off-label nasogastric administration of oral ibuprofen in preterm infants with PDA...
September 2010: Clinical Therapeutics
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