A conservative treatment of patent ductus arteriosus in very low birth weight infants

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11120%2F17%3A43912817" target="_blank" >RIV/00216208:11120/17:43912817 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00023698:_____/17:N0000027

Výsledek na webu

<a href="http://dx.doi.org/10.1016/j.earlhumdev.2016.12.008" target="_blank" >http://dx.doi.org/10.1016/j.earlhumdev.2016.12.008</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.earlhumdev.2016.12.008" target="_blank" >10.1016/j.earlhumdev.2016.12.008</a>

Jazyk výsledku

angličtina

Název v původním jazyce

A conservative treatment of patent ductus arteriosus in very low birth weight infants

Popis výsledku v původním jazyce

Background Treatment of the patent ductus arteriosus (PDA) in the preterm infant remains contentious. There are numerous options of the PDA management from early targeted treatment, late (symptomatic) treatment to no treatment at all. Aims To evaluate a three different PDA management approaches in very low birth weight (VLBW) infants. Study design A retrospective observational time series study of three cohorts of VLBW infants born between 2004 and 2011. Subjects Infants in Symptomatic Treatment Group (STG) were echocardiographically evaluated when clinical signs suggestive of a PDA were present and treated if a haemodynamically significant PDA was confirmed. Early Targeted Group (ETG) underwent echocardiography within the first 48 h and infants received ibuprofen if a large PDA was present. Conservative Treatment Group (CTG) was screened by echocardiography on day seven of life; patients with PDA were managed with increased positive end expiratory pressure and fluid restriction as a first line intervention. Outcomes The primary outcome was medical and surgical treatment in the three time periods. Secondary outcomes included mortality, severe periventricular and intraventricular haemorrhage, respiratory distress syndrome and chronic lung disease. Results There were 138 infants diagnosed with PDA; 52 infants in STG, 52 infants in ETG and 34 infants in CTG. Ibuprofen therapy and ligation were less frequent in CTG. There was significantly decreased incidence of chronic lung disease in CTG compared to STG (18% vs. 51%; p = 0.003) and to ETG (18% vs. 46%; p = 0.02). There was no difference in the other short term outcomes. Conclusion Conservative treatment of persistent ductus arteriosus in VLBW infants is a feasible option and future randomized trials of conservative management are warranted.

Název v anglickém jazyce

A conservative treatment of patent ductus arteriosus in very low birth weight infants

Popis výsledku anglicky

Background Treatment of the patent ductus arteriosus (PDA) in the preterm infant remains contentious. There are numerous options of the PDA management from early targeted treatment, late (symptomatic) treatment to no treatment at all. Aims To evaluate a three different PDA management approaches in very low birth weight (VLBW) infants. Study design A retrospective observational time series study of three cohorts of VLBW infants born between 2004 and 2011. Subjects Infants in Symptomatic Treatment Group (STG) were echocardiographically evaluated when clinical signs suggestive of a PDA were present and treated if a haemodynamically significant PDA was confirmed. Early Targeted Group (ETG) underwent echocardiography within the first 48 h and infants received ibuprofen if a large PDA was present. Conservative Treatment Group (CTG) was screened by echocardiography on day seven of life; patients with PDA were managed with increased positive end expiratory pressure and fluid restriction as a first line intervention. Outcomes The primary outcome was medical and surgical treatment in the three time periods. Secondary outcomes included mortality, severe periventricular and intraventricular haemorrhage, respiratory distress syndrome and chronic lung disease. Results There were 138 infants diagnosed with PDA; 52 infants in STG, 52 infants in ETG and 34 infants in CTG. Ibuprofen therapy and ligation were less frequent in CTG. There was significantly decreased incidence of chronic lung disease in CTG compared to STG (18% vs. 51%; p = 0.003) and to ETG (18% vs. 46%; p = 0.02). There was no difference in the other short term outcomes. Conclusion Conservative treatment of persistent ductus arteriosus in VLBW infants is a feasible option and future randomized trials of conservative management are warranted.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30209 - Paediatrics

Projekt

—

Návaznosti

S - Specificky vyzkum na vysokych skolach

Rok uplatnění

2017

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Early Human Development

ISSN

0378-3782

e-ISSN

—

Svazek periodika

104

Číslo periodika v rámci svazku

January

Stát vydavatele periodika

IE - Irsko

Počet stran výsledku

5

Strana od-do

45-49

Kód UT WoS článku

000394201100009

EID výsledku v databázi Scopus

2-s2.0-85007545142