Is late treatment with acetaminophen safe and effective in avoiding surgical ligation among extremely preterm neonates with persistent patent ductus arteriosus?
J Perinatol
; 41(10): 2519-2525, 2021 10.
Article
em En
| MEDLINE
| ID: mdl-34453113
ABSTRACT
OBJECTIVE:
Evaluate the association of late treatment with acetaminophen vs. immediate surgical ligation with death or neurodevelopmental impairment (NDI) among extremely low gestational age neonates (ELGANs) with persistent patent ductus arteriosus (pPDA). STUDYDESIGN:
Retrospective comparative epoch study of ELGANs with pPDA being considered for surgical ligation. ELGANs in epoch 1 (2009-2012) were referred for ligation, while infants in epoch 2 (2012-2015) were treated with oral acetaminophen and referred for ligation in the absence of improvement. The primary outcome was a composite of death/NDI at 18-24 months.RESULTS:
Ninety-two ELGANs with median[IQR] GA 25.2 weeks [24.4, 26.3] had pPDA (43 in epoch 1, 49 in -epoch 2) with acetaminophen-exposed neonates receiving 7 days [7, 7] of treatment. ELGANs in epoch 2 had reduced ligation (aOR 0.30; 95%CI [0.11, 0.87]), but there was no difference in death/NDI (aOR 1.03; 95%CI [0.30, 3.56]).CONCLUSIONS:
Late treatment with acetaminophen to avoid surgery for pPDA is associated with reduced ligation but no difference in death/NDI, supporting the safety and effectiveness of this approach.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Contexto em Saúde:
2_ODS3
/
6_ODS3_enfermedades_notrasmisibles
/
7_ODS3_muertes_prevenibles_nacidos_ninos
Problema de saúde:
2_muertes_prevenibles
/
6_cardiovascular_diseases
/
6_congenital_chromosomal_anomalies
/
6_other_circulatory_diseases
/
7_neonatal_care_health
Assunto principal:
Permeabilidade do Canal Arterial
/
Acetaminofen
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Humans
/
Infant
/
Newborn
Idioma:
En
Revista:
J Perinatol
Assunto da revista:
PERINATOLOGIA
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Canadá