ASSOCIATION OF PATENT DUCTUS ARTERIOSUS SIZE WITH CLINICAL FEATURES AND SHORT-TERM OUTCOMES IN PRETERM INFANTS LESS THAN 34 WEEKS

Abstract Background Controversy exists about the optimal management of a patent ductus arteriosus (PDA) in preterm infants. A persistent PDA is associated with neonatal mortality and morbidity, but causality remains unproven. Although both pharmacological and/or surgical treatment are effective in PDA closure, this has not resulted in an improved neonatal outcome. In most preterm infants, a PDA will eventually close spontaneously, hence PDA treatment potentially increases the risk of iatrogenic adverse effects. Therefore, expectant management is gaining interest, even in the absence of convincing evidence to support this strategy. Methods/design The BeNeDuctus trial is a multicentre, randomised, non-inferiority trial assessing early pharmacological treatment (24–72 h postnatal age) with ibuprofen versus expectant management of PDA in preterm infants in Europe. Preterm infants with a gestational age of less than 28 weeks and an echocardiographic-confirmed PDA with a transductal diameter of > 1.5 mm are randomly allocated to early pharmacological treatment with ibuprofen or expectant management after parental informed consent. The primary outcome measure is the composite outcome of mortality, and/or necrotizing enterocolitis Bell stage ≥ IIa, and/or bronchopulmonary dysplasia, all established at a postmenstrual age of 36 weeks. Secondary short-term outcomes are comorbidity and adverse events assessed during hospitalization and long-term neurodevelopmental outcome assessed at a corrected age of 2 years. This statistical analysis plan focusses on the short-term outcome and is written and submitted without knowledge of the data. Trial registration ClinicalTrials.gov NTR5479. Registered on October 19, 2015, with the Dutch Trial Registry, sponsored by the United States National Library of Medicine Clinicaltrials.gov NCT02884219 (registered May 2016) and the European Clinical Trials Database EudraCT 2017-001376-28.

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Short‐term ventriculo‐arterial coupling and myocardial work efficiency in preterm infants undergoing percutaneous patent ductus arteriosus closure

Physiological Reports ◽

10.14814/phy2.15108 ◽

2021 ◽

Vol 9 (22) ◽

Author(s):

Adrianne R. Bischoff ◽

Amy H. Stanford ◽

Patrick J. McNamara

Keyword(s):

Patent Ductus Arteriosus ◽

Preterm Infants ◽

Ductus Arteriosus ◽

Work Efficiency ◽

Short Term ◽

Patent Ductus Arteriosus Closure ◽

Patent Ductus

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Using benchmarking to identify inter-centre differences in persistent ductus arteriosus treatment: can we improve outcome?

Cardiology in the Young ◽

10.1017/s104795111700052x ◽

2017 ◽

Vol 27 (8) ◽

pp. 1488-1496 ◽

Cited By ~ 3

Author(s):

Esther J. S. Jansen ◽

Koen P. Dijkman ◽

Richard A. van Lingen ◽

Willem B. de Vries ◽

Daniel C. Vijlbrief ◽

...

Keyword(s):

Patent Ductus Arteriosus ◽

Preterm Infants ◽

Standard Procedure ◽

Ductus Arteriosus ◽

Short Term ◽

Surgical Ligation ◽

Persistent Ductus Arteriosus ◽

Ductal Closure ◽

Neonatal Icu ◽

Patent Ductus

AbstractObjectiveThe aim of this study was to identify inter-centre differences in persistent ductus arteriosus treatment and their related outcomes.Materials and methodsWe carried out a retrospective, multicentre study including infants between 24+0 and 27+6 weeks of gestation in the period between 2010 and 2011. In all centres, echocardiography was used as the standard procedure to diagnose a patent ductus arteriosus and to document ductal closure.ResultsIn total, 367 preterm infants were included. All four participating neonatal ICU had a comparable number of preterm infants; however, differences were observed in the incidence of treatment (33–63%), choice and dosing of medication (ibuprofen or indomethacin), number of pharmacological courses (1–4), and the need for surgical ligation after failure of pharmacological treatment (8–52%). Despite the differences in treatment, we found no difference in short-term morbidity between the centres. Adjusted mortality showed independent risk contribution of gestational age, birth weight, ductal ligation, and perinatal centre.ConclusionsUsing benchmarking as a tool identified inter-centre differences. In these four perinatal centres, the factors that explained the differences in patent ductus arteriosus treatment are quite complex. Timing, choice of medication, and dosing are probably important determinants for successful patent ductus arteriosus closure.

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Short-Term Outcome Of Different Treatment Modalities Of Patent Ductus Arteriosus In Preterm Infants. Five Years Experiences In Qatar

The Internet Journal of Cardiovascular Research ◽

10.5580/2b49 ◽

2012 ◽

Vol 7 (2) ◽

Keyword(s):

Patent Ductus Arteriosus ◽

Preterm Infants ◽

Ductus Arteriosus ◽

Treatment Modalities ◽

Short Term ◽

Term Outcome ◽

Short Term Outcome ◽

Patent Ductus

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Ligation of patent ductus arteriosus through anterior thoracotomy in preterm infants: a 10-year experience

Cardiology in the Young ◽

10.1017/s1047951121000032 ◽

2021 ◽

pp. 1-7

Author(s):

Arif Selcuk ◽

Murat Cicek ◽

Okan Yurdakok ◽

Yigit Kilic ◽

Filiz İzgi Coskun ◽

...

Keyword(s):

Patent Ductus Arteriosus ◽

Preterm Infants ◽

Ductus Arteriosus ◽

Median Sternotomy ◽

Mortality Rates ◽

Short Term ◽

Intraoperative Bleeding ◽

Significant Difference ◽

Mini Thoracotomy ◽

Patent Ductus

Abstract Objective: The aim of this study is to report on the short-term and mid-term outcomes of preterm infants who underwent patent ductus arteriosus ligation through anterior mini-thoracotomy. Methods: Data for 103 preterm infants who underwent patent ductus arteriosus clipping through an anterior mini-thoracotomy at the 2nd intercostal space between 2009 and 2019 were retrospectively reviewed. The patients were divided into two groups according to their weight at the time of surgery. The complications, morbidity, and mortality rates of each group were compared at postoperative day 30 and at the end of 1 year after surgery. Results: During the operation, the median weight of the patients was 900 g (IQR 800–1125 g), the median age was 21 days (IQR 14.5–29 days). The lowest body weight was 460 g. In three patients (3%), there was intraoperative bleeding from the patent ductus arteriosus that required transition to median sternotomy. In one patient (1%) a residual patent ductus arteriosus that required reoperation was observed. Twelve patients (12%) died in the first 30 days postoperatively. Six patients (6%) died between the postoperative day 30 and 1 year. There was no statistically significant difference in the rates of mortality, morbidity, and complication between the groups. Conclusions: Based on our observations of over a hundred preterm infants with patent ductus arteriosus over a decade, ligation through anterior mini-thoracotomy is the main surgical procedure of choice for this patient group in our clinic. Our findings demonstrate the safety of this approach and we believe that it can be successfully replicated in other institutions.

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