scholarly journals Bedside surgical ligation of the patent ductus arteriosus in very‐low‐birth‐weight premature infants: Limited upper ministernotomy as an alternative approach

2020 ◽  
Author(s):  
Muhammet Akyuz ◽  
Onur Isik ◽  
Ilker Mercan ◽  
Meltem Cakmak
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Patent Ductus Arteriosus ◽  
Premature Infants ◽  
Very Low Birth Weight ◽  
Ductus Arteriosus ◽  
Surgical Ligation ◽  
Alternative Approach ◽  
Patent Ductus

scholarly journals Ligation of patent ductus arteriosus in very low birth weight premature infants

2020 ◽  
Vol 61 (4) ◽  
pp. 399-405
Author(s):  
Hasan F. Othman ◽  
Debra T. Linfield ◽  
Mohamed A. Mohamed ◽  
Hany Aly
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Patent Ductus Arteriosus ◽  
Premature Infants ◽  
Very Low Birth Weight ◽  
Ductus Arteriosus ◽  
Patent Ductus

Indomethacin Therapy for Large Patent Ductus Arteriosus in the Very Low Birth Weight Infant: Results and Complications

PEDIATRICS ◽  
1979 ◽  
Vol 64 (2) ◽  
pp. 154-159
Author(s):  
H. L. Halliday ◽  
T. Hirata ◽  
J. P. Brady
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Patent Ductus Arteriosus ◽  
Very Low Birth Weight ◽  
Ductus Arteriosus ◽  
Base Deficit ◽  
Low Birth Weight Infants ◽  
Low Birth Weight Infant ◽  
Surgical Ligation ◽  
Patent Ductus

Of 36 very low birth weight infants (<1,500 gm) with large patent ductus arteriosus, 24 (67%) showed satisfactory constriction or closure after indomethacin therapy (mean total dose 0.4 mg/kg). Twelve infants (33%) responded inadequately with seven infants requiring surgical ligation. Response was better in infants 8 to 14 days old compared to those more than 14 days old (89% vs 33%, P = .048) irrespective of birth weight or gestational age. Major complications were renal and unrelated to ductus response. Urine output fell significantly (3.65 to 1.63 ml/kg/hr, P < .001) and in 47% of infants serum creatinine increased ≥1.5 mg/dl. Creatinine was less likely to rise in infants more than 14 days old. Hyponatremia was found in 36% of infants. Serum potassium increased more frequently in infants more than 8 days old and was >6.0 mEq/liter in 25%. Indomethacin caused a reduction in PaCO2 (41 to 37 mm Hg, P < .01) and an increase in pH (7.32 to 7.36, P < .02) with no change in base deficit. These changes occurred even in the absence of clinical ductus closure. No other side effects of indomethacin therapy were noted. Three infants died but death was unrelated to indomethacin therapy. Overall survival was 92%, and nine infants (25%) developed mild bronchopulmonary dysplasia.

scholarly journals Surgical ligation of patent ductus arteriosus in very low birth weight infants: A 9-year single center experience

2020 ◽  
Author(s):  
Jun Ho Lee ◽  
Hyun Ju Lee ◽  
Hyun-Kyung Park ◽  
Ja-Hye Ahn ◽  
Hee Sun Kim ◽  
...  
Keyword(s):  
Birth Weight ◽  
Surgical Treatment ◽  
Low Birth Weight ◽  
Patent Ductus Arteriosus ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Ductus Arteriosus ◽  
Low Birth Weight Infants ◽  
Surgical Ligation ◽  
Patent Ductus

Abstract Background We analyzed the feasibility and outcomes of early surgical ligation in very low birth weight infants (VLBWIs) with hemodynamically significant patent ductus arteriosus (HSPDA) and investigated predictors for surgical treatment after unsuccessful medical management. Methods Medical records from the neonatal intensive care unit of Hanyang University Seoul Hospital from January 2010 to December 2018 were retrospectively reviewed. 233 VLBWIs with HSPDA were enrolled in our study. Of these infants, 134 underwent surgical ligation and were subdivided into the early ligation group (n = 49; within 10 days of age) and the late ligation group (n = 85; after 10 days of age). Results The mean gestational age and birth weight were significantly lower in the patent ductus arteriosus (PDA) ligation group than in the Non-ligation group (p < 0.001). PDA ductal diameter > 2.0 mm (p < 0.001), low Apgar score at 5 minutes (p = 0.033), and chorioamnionitis (p = 0.037) were the predictors for receiving surgical treatment for PDA. Early ligation was significantly associated with a low incidence of culture-proven sepsis (p = 0.004), mechanical ventilator time > 4 weeks (p = 0.007), necrotizing enterocolitis stage (NEC) ≥ III (p = 0.022), and intraventricular hemorrhage (IVH) grade ≥ III (p = 0.035). Conclusions Early surgical ligation minimizes adverse effects of HSPDA in predicted infants who subsequently require surgical treatment for PDA. We suggest that predicted VLBWIs with HSPDA that is unresponsive to medical treatment should avoid delayed ductal closure to reduce severe NEC, severe IVH, culture-proven sepsis, and facilitate earlier endotracheal extubation.

scholarly journals The optimal timing of surgical ligation of patent ductus arteriosus in preterm or very-low-birth-weight infants

Medicine ◽  
2020 ◽  
Vol 99 (9) ◽  
pp. e19356
Author(s):  
Hualin Yan ◽  
Fan Ma ◽  
Yifei Li ◽  
Kaiyu Zhou ◽  
Yimin Hua ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Patent Ductus Arteriosus ◽  
Very Low Birth Weight ◽  
Ductus Arteriosus ◽  
Optimal Timing ◽  
Low Birth Weight Infants ◽  
Surgical Ligation ◽  
Patent Ductus

Serum Endocan Level as a Predictive Marker for Hemodynamically Significant Patent Ductus Arteriosus in Very Low Birth Weight İnfants

2017 ◽  
Vol 34 (13) ◽  
pp. 1312-1317 ◽  
Author(s):  
Cuneyt Tayman ◽  
Ufuk Cakır ◽  
Mehmet Buyuktiryaki ◽  
Utku Serkant ◽  
Serife Oğuz ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Patent Ductus Arteriosus ◽  
Premature Infants ◽  
Very Low Birth Weight ◽  
Ductus Arteriosus ◽  
Control Group ◽  
Study Group ◽  
Low Birth Weight Infants ◽  
Patent Ductus

Background Diagnosis and treatment of patent ductus arteriosus (PDA) in premature infants is still an important problem for clinicians. Echocardiography is the gold standard for determination of PDA based on clinical and hemodynamic significance. Clinical decision making may be aided by measuring circulating biomarkers such as natriuretic and endothelial propeptides. We aimed to investigate the significance of serum endocan and B-type natriuretic peptide (BNP) in the diagnosis and follow-up of hemodynamically significant PDA (hsPDA) in very low birth weight infants. Materials and Methods In this study, 84 premature infants with gestation age less than 32 weeks were included. Forty-two premature infants with hsPDA were determined as the study group and 42 premature infants without PDA were assigned as the control group. Blood samples were collected and analyzed for serum endocan and pro-BNP levels. Results Serum levels of pro-BNP and endocan in the study group at the time of diagnosis of PDA were found to be significantly higher than the control group, and the levels decreased significantly after medication. Multivariate regression analysis showed that birth weight and the presence of PDA were significantly correlated with serum endocan levels. The cutoff values of pro-BNP and endocan for PDA prediction were 290 pg/mL and 506 ng/mL, respectively. Conclusion Endocan and pro-BNP assays have clinical importance in the diagnosis, initiation therapy, and follow response to therapy in very low birth weight infants with hsPDA.

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