Patent Ductus Arteriosus and the Effects of Its Late Closure in Preterm Infants with Severe Bronchopulmonary Dysplasia.
Neonatology
; 116(3): 236-243, 2019.
Article
en En
| MEDLINE
| ID: mdl-31269508
ABSTRACT
BACKGROUND:
The natural history and optimal management of a patent ductus arteriosus (PDA) among infants with established severe bronchopulmonary dysplasia (sBPD) remains uncertain.OBJECTIVES:
To describe the characteristics of PDA present at ≥36 weeks' postmenstrual age (PMA) and the effects of late surgical PDA closure in a referral cohort of very preterm infants with sBPD. STUDYDESIGN:
This retrospective cohort study was performed in a tertiary neonatal intensive care unit. Study infants were born at <32 weeks' gestation between 2010 and 2016, diagnosed with sBPD, and had an echocardiographic PDA at ≥36 weeks' PMA. We reviewed echocardiograms performed closest to 3 time points (≥36 weeks' PMA, hospital discharge, and 1 year of age) and assessed clinical outcomes among infants with versus without late PDA treatment.RESULTS:
Among 329 infants with sBPD, 59 had a PDA at ≥36 weeks' PMA. Most PDAs were small (n = 33) and shunted left to right (n = 53). The PDA closed spontaneously prior to discharge in 5 of 21 infants who did not undergo surgical closure and decreased in size in 3. The PDA spontaneously closed by 1 year of age in 6 out of 12 infants with an open duct at discharge. PDA surgery (n = 23) at ≥36 weeks' PMA was not associated with increased risk for the composite outcome of tracheostomy, systemic vasodilator at discharge, or death after adjusting for potential confounders (OR 3.2, 95% CI 0.81-13.0).CONCLUSIONS:
The majority of conservatively treated late PDAs closed spontaneously or decreased in size.PDA surgery was not associated with severe adverse clinical outcomes.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Displasia Broncopulmonar
/
Recien Nacido Prematuro
/
Nacimiento Prematuro
/
Conducto Arterioso Permeable
/
Tiempo de Tratamiento
/
Tratamiento Conservador
/
Procedimientos Quirúrgicos Cardíacos
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Límite:
Female
/
Humans
/
Infant
/
Male
/
Newborn
País/Región como asunto:
Europa
Idioma:
En
Revista:
Neonatology
Asunto de la revista:
PERINATOLOGIA
Año:
2019
Tipo del documento:
Article