scholarly journals Evidence for the Management of Bronchopulmonary Dysplasia in Very Preterm Infants

Children ◽  
2021 ◽  
Vol 8 (4) ◽  
pp. 298
Author(s):  
Tobias Muehlbacher ◽  
Dirk Bassler ◽  
Manuel B. Bryant
Keyword(s):  
Nitric Oxide ◽  
Pulmonary Hypertension ◽  
Stem Cell ◽  
Cell Therapy ◽  
Ductus Arteriosus ◽  
Antenatal Corticosteroids ◽  
Very Preterm ◽  
Surfactant Replacement Therapy ◽  
Ventilation Strategies ◽  
Patent Ductus

Background: Very preterm birth often results in the development of bronchopulmonary dysplasia (BPD) with an inverse correlation of gestational age and birthweight. This very preterm population is especially exposed to interventions, which affect the development of BPD. Objective: The goal of our review is to summarize the evidence on these daily procedures and provide evidence-based recommendations for the management of BPD. Methods: We conducted a systematic literature research using MEDLINE/PubMed on antenatal corticosteroids, surfactant-replacement therapy, caffeine, ventilation strategies, postnatal corticosteroids, inhaled nitric oxide, inhaled bronchodilators, macrolides, patent ductus arteriosus, fluid management, vitamin A, treatment of pulmonary hypertension and stem cell therapy. Results: Evidence provided by meta-analyses, systematic reviews, randomized controlled trials (RCTs) and large observational studies are summarized as a narrative review. Discussion: There is strong evidence for the use of antenatal corticosteroids, surfactant-replacement therapy, especially in combination with noninvasive ventilation strategies, caffeine and lung-protective ventilation strategies. A more differentiated approach has to be applied to corticosteroid treatment, the management of patent ductus arteriosus (PDA), fluid-intake and vitamin A supplementation, as well as the treatment of BPD-associated pulmonary hypertension. There is no evidence for the routine use of inhaled bronchodilators and prophylactic inhaled nitric oxide. Stem cell therapy is promising, but should be used in RCTs only.

scholarly journals Patent ductus arteriosus, systemic NT-proBNP concentrations and development of bronchopulmonary dysplasia in very preterm infants: retrospective data analysis from a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Solomiia Potsiurko ◽  
Dmytro Dobryanskyy ◽  
Lesya Sekretar
Keyword(s):  
Randomized Controlled Trial ◽  
Patent Ductus Arteriosus ◽  
Preterm Infants ◽  
Roc Curve ◽  
Controlled Trial ◽  
Ductus Arteriosus ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Randomized Controlled ◽  
Patent Ductus

Abstract Background Patent ductus arteriosus (PDA) is a common complication in very preterm infants. It is known that there is an association between PDA and development of bronchopulmonary dysplasia (BPD) or death before the postmenstrual age (PMA) of 36 weeks, but this association remains one of the most controversial aspects of the problem. The study aimed to evaluate the relationship between PDA, serum NT-proBNP levels at 2–3 and 8–9 days of life, and BPD/death in very preterm infants. Methods Data of 52 preterm infants with a gestational age < 32 weeks, chronological age < 72 h, and PDA diameter > 1.5 mm, enrolled in a randomized controlled trial, were used for the retrospective analysis. All patients underwent daily echocardiographic and two serum NT-proBNP measurements within the first 10 days after birth. Two groups of infants were formed retrospectively at PMA of 36 weeks depending on the outcome, BPD (n = 18)/death (n = 7) or survival without BPD (n = 27). Receiver operator characteristic (ROC) curve was used to evaluate the predictive performance of serum NT-proBNP levels for BPD/death occurrence. Results The percentage of infants who received pharmacological treatment for PDA did not differ between the groups. Based on the area under the ROC curve, serum NT-proBNP levels on the 2–3 day of life (AUC = 0.71; 95% confidence interval (CI): 0.56–0.9; p = 0.014)) and on the 8–9 day of life (AUC = 0.76; 95% CI: 0.6–0.9; p = 0.002) could reliably predict BPD/death in very preterm infants who had PDA diameter > 1.5 mm in the first 72 h of life. Hemodynamically significant PDA (hsPDA) was significantly more often detected in newborns with BPD/death, however, treatment of infants with hsPDA did not reduce the incidence of BPD/death. Conclusions In very preterm infants with PDA > 1.5 mm at the age of 24–48 h, serum NT-proBNP concentration could reliably predict the development of BPD or death, regardless of the persistence of PDA, with the highest diagnostic value at 8–9 days. Trial registration This study is registered in ClinicalTrials.gov - NCT03860428 on March 4, 2019.

PATENT DUCTUS ARTERIOSUS WITH PULMONARY HYPERTENSION

1956 ◽  
Vol 31 (3) ◽  
pp. 268-285
Author(s):  
F. Henry Ellis ◽  
John W. Kirklin ◽  
John A. Callahan ◽  
Earl H. Wood
Keyword(s):  
Pulmonary Hypertension ◽  
Patent Ductus Arteriosus ◽  
Ductus Arteriosus ◽  
Patent Ductus

Anterior mini-thoracotomy versus transcatheter closure of patent ductus arteriosus in very preterm infants

2021 ◽  
Vol 13 (4) ◽  
pp. 282-283
Author(s):  
Chloé Wanert ◽  
Marien Lenoir ◽  
Damien Bonnet ◽  
Mathilde Meot ◽  
Virginie Fouilloux ◽  
...  
Keyword(s):  
Patent Ductus Arteriosus ◽  
Preterm Infants ◽  
Transcatheter Closure ◽  
Ductus Arteriosus ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Mini Thoracotomy ◽  
Patent Ductus

scholarly journals Intracardiac and External Phonocardiographic Study in Infant with Patent Ductus Arteriosus and Pulmonary Hypertension

1968 ◽  
Vol 32 (11) ◽  
pp. 1571-1577 ◽  
Author(s):  
HIROHISA KATO ◽  
TEIICHI ODA ◽  
MIZUO HIROSE ◽  
YOSHIAKI YOSHIZAWA ◽  
KAZUO URYU ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Patent Ductus Arteriosus ◽  
Ductus Arteriosus ◽  
Patent Ductus

scholarly journals MANAGEMENT OF HYPERTENSIVE PDA

2021 ◽  
Vol 70 (Suppl-4) ◽  
pp. S701-05
Author(s):  
Khushal Khan Khattak ◽  
Maad Ullah ◽  
Abdul Malik Sheikh ◽  
Asma Kanwal ◽  
Sajid Ali Shah ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Pulmonary Artery ◽  
Patent Ductus Arteriosus ◽  
Palliative Treatment ◽  
Ductus Arteriosus ◽  
Treatment Options ◽  
Device Closure ◽  
Surgical Ligation ◽  
Percutaneous Catheter ◽  
Patent Ductus

Objective: To determine different treatment options in patients of Patent Ductus Arteriosus with pulmonary hypertension beyond neonatal period. Study Design: Descriptive cross sectional study. Place and Duration of Study: This study was carried out in Pediatric Cardiology department of Rawalpindi Institute of Cardiology, from Jan 2017 to Jan 2019. Methodology: Patients having PDA with pulmonary hypertension were included in the study. Treatment options were divided into percutaneous catheter device closure, surgical ligation of patent ductus arteriosus and palliative treatment. Any adverse event during the procedure was documented. Stratification was done in regard to gender and age group. Post stratification chi square test was applied and p-value less than or equal to 0.05 was considered as significant. Results: Total number of patients included in the study were 37. Mean age (years) of patients (Mean ± SD) was 19.21 ± 8.76. Mean ± SD pulmonary artery pressure was 56.43 ± 11.55 mmHg. Percutaneous catheter device closure was successful in 24 (64.9%) patients, in 7 (18.9%) patients primary surgical PDA ligation was done, 3 (8.1%) patients were advised palliative treatment and in 3 (8.1%) patients adverse events occurred during percutaneous device closure and were thus referred for surgical ligation. Patent ductus Arteriosus Occlutech device was used in 18 (48.6%) patients, Occlutech VSD device was used in 7 (18.5%) patients and in 1 (2.7%) patient AGA duct occluder was used. Conclusion: In patients with patent ductus arteriosus and pulmonary artery hypertension, percutaneous catheter device closure is a safe and effective procedure.

Elongated Patent Ductus Arteriosus with Intermittent Shunting

PEDIATRICS ◽  
1967 ◽  
Vol 39 (3) ◽  
pp. 446-448
Author(s):  
COLETTE M. KOHLER ◽  
DAN G. MCNAMARA
Keyword(s):  
Pulmonary Hypertension ◽  
Case Report ◽  
Patent Ductus Arteriosus ◽  
Premature Infants ◽  
Ductus Arteriosus ◽  
Cardiac Defects ◽  
Cardiac Catheterizations ◽  
Delayed Closure ◽  
Patent Ductus

The presence of patent ductus arteriosus without a typical continuous murmur has long been recognized, especially in the presence of pulmonary hypertension, or a small ductus, or with associated cardiac defects; however, there are only a few reports of documented, intermittently disappearing murmurs occurring in individuals over 6 months of age with a substantial shunt in the absence of pulmonary hypertension or associated defects. Danilowicz, et al. have recently reported delayed closure of the ductus anteriosus up to 6 months of age in some premature infants. We present this case report of a 2½-year-old boy with patent ductus arteriosus with cardiac catheterizations during the disappearance and subsequent reappearance of a continuous murmur with documentation of absence of shunting when the murmur was absent and substantial shunting if the murmur was present.

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