Management and outcomes of concurrent patent ductus arteriosus and necrotising enterocolitis in preterm infants in a surgical neonatal intensive care unit

2011 ◽  
Vol 96 (Supplement 1) ◽  
pp. Fa25-Fa26
Author(s):  
A. Stewart ◽  
A. Heuchan ◽  
N. Patel ◽  
G. Walker
2020 ◽  
Vol 68 (1) ◽  
Author(s):  
Reem M. Soliman ◽  
Fatma Alzahraah Mostafa ◽  
Antoine Abdelmassih ◽  
Elham Sultan ◽  
Dalia Mosallam

Abstract Background Patent ductus arteriosus poses diagnostic and therapeutic dilemma for clinicians, diagnosis of persistent PDA, and determination of its clinical and hemodynamic significance are challenging. The aim of this study is to determine the prevalence of PDA in preterm infants admitted to our NICU, to report cardiac and respiratory complications of PDA, and to study the management strategies and their subsequent outcomes. Result Echocardiography was done for 152 preterm babies admitted to neonatal intensive care unit (NICU) on day 3 of life. Eighty-seven (57.2%) preterms had PDA; 54 (62.1%) non-hemodynamically significant PDA (non-hsPDA), and 33 (37.9%) hemodynamically significant PDA. Hemodynamically significant PDA received medical treatment (paracetamol 15 mg/kg/6 h IV for 3 days). Follow-up echocadiography was done on day 7 of life. Four babies died before echo was done on day 7. Twenty babies (68.9%) achieved closure after 1st paracetamol course. Nine babies received 2nd course paracetamol. Follow-up echo done on day 11 of life showed 4 (13.7%) babies achieved successful medical closure after 2nd paracetamol course; 5 babies failed closure and were assigned for surgical ligation. The group of non-hsPDA showed spontaneous closure after conservative treatment. Pulmonary hemorrhage was significantly higher in hsPDA group. Mortality was higher in hsPDA group than non-hsPDA group. Conclusion Echocardiographic evaluation should be done for all preterms suspected clinically of having PDA. We should not expose vulnerable population of preterm infants to medication with known side effects unnecessarily; we should limit medical closure of PDA to hsPDA. Paracetamol offers several important therapeutic advantages options being well tolerated and having more favorable side effects profile.


PEDIATRICS ◽  
1983 ◽  
Vol 72 (4) ◽  
pp. 580-581
Author(s):  
IRAJ A. KASHANI ◽  
RICHARD E. SWENSSON ◽  
T. ALLEN MERRITT

To the Editor.— We read with interest the article by Ellison et al1 on evaluation of preterm infants for patent ductus arteriosus. While commending the study for its elaborate design, we believe that in the modern neonatal intensive care unit there is a need for a less cumbersome and more practical approach to this common problem. The criteria for detecting patent ductus arteriosus (PDA) in the presence of a continuous or systolic murmur presented in this paper are well founded, and the figures on the incidence of PDA are in agreement with some studies that have primarily relied on the murmur as the key feature.2,3


2010 ◽  
Vol 86 ◽  
pp. S40
Author(s):  
Avyaz Aydogdu ◽  
Bilin Cetinkaya Cakmak ◽  
Ali Rahmi Bakiler ◽  
Defne Engur ◽  
Munevver Kaynak Turkmen

1986 ◽  
Vol 152 (6) ◽  
pp. 704-708 ◽  
Author(s):  
Robert L. Taylor ◽  
Frederick L. Grover ◽  
P.Kent Harman ◽  
Marilyn K. Escobedo ◽  
Rajam S. Ramamurthy ◽  
...  

PEDIATRICS ◽  
1987 ◽  
Vol 79 (4) ◽  
pp. 654-654
Author(s):  
WARREN ROSENFELD

Dr Ward points to two major problems that we discussed in our paper. At the time this study was begun in our neonatal intensive care unit, only M-mode echocardiography was available. We agree our methods were relatively gross estimations of ductal patency, and we are presently studying the effect of phototherapy using two-dimensional and Doppler echocardiography. The second flaw of nonblinding was an extremely difficult one to solve in our unit. Those physicians involved in the study spent considerable time in the unit and, even if shields were removed during the scheduled daily examination, it would be difficult to truly blind observers because shields would have been replaced.


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