scholarly journals Bedside Surgery to Treat Patent Ductus Arteriosus in Low-Birth-Weight Premature Infants

2014 ◽  
Vol 7 ◽  
pp. OJCS.S16156
Author(s):  
Gökhan Albayrak ◽  
Koray Aykut ◽  
Mustafa Karacelik ◽  
Ramazan Soylar ◽  
Kemal Karaarslan ◽  
...  
Keyword(s):  
Birth Weight ◽  
Patent Ductus Arteriosus ◽  
Medical Treatment ◽  
Premature Infants ◽  
Ductus Arteriosus ◽  
Mortality And Morbidity ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Patent Ductus

Background Patent ductus arteriosus (PDA) is commonly seen in premature infants with low birth weights (LBW). It is a condition that has high mortality and morbidity rates. Early closure of the ductus arteriosus may require surgery or medical treatment. However, the decision of first medical approach for symptomatic PDA closure is still debated. In this study, we compared the surgical and medical treatments for the closure of PDA in premature LBW infants. Methods This study included 27 premature infants whose birth weights were lower than 1500 g, who were born in the period between 2011 and 2013 and had symptomatic PDA. Patients were separated into two groups: groups A and B. Group A included patients whose PDAs were closed with medical treatment ( n = 16), and group B included patients who had undergone surgical operations for PDA closure ( n = 11). Results There were no statistically significant differences between groups A and B when the groups were compared in terms of birth weight, gestational age, respiratory distress syndrome (RDS), necrotizing enterocolitis (NEC), sepsis, intraventricular hemorrhage (IVH), retinopathy of prematurity (ROP), and pneumothorax. Although the mortality rate was determined to be lower in group B (2 out of 11, 18.1%) than in group A (7 out of 16, 43.7%), no statistically significant difference was found between the two groups. A statistically significant increase was determined in the incidence of kidney function loss in patient group that received Ibuprofen, a medical treatment, in comparison to the patients who had surgery. Conclusion In conclusion, surgery is a safe method to repair PDA in premature LBW infants. Although there is no remarkable difference between surgery and medical treatment, we suggest that a surgical approach may be used as a first choice to repair PDA considering the lower rate of mortality and morbidity and higher rate of closure compared to medical treatment.

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

scholarly journals SAFETY AND QUALITY OF INTRAVENOUS LIPIDS FOR NEWBORNS: EFFECTS ON CRITICAL DISEASES AND METABOLIC DISORDERS (PART II)

2021 ◽  
Vol 11 (4(42)) ◽  
pp. 68-74
Author(s):  
I. Anikin ◽  
V. Snisar
Keyword(s):  
Birth Weight ◽  
Patent Ductus Arteriosus ◽  
Premature Infants ◽  
Intraventricular Hemorrhage ◽  
Metabolic Disorders ◽  
Ductus Arteriosus ◽  
Lipid Emulsions ◽  
Intravenous Lipids ◽  
Patent Ductus

Premature birth and its complications cause stress in newborns, which restrains their physical growth for several weeks after birth and is associated with chronic morbidity and neurological disability in the future. Preterm infants face such difficulties as respiratory distress, cardiovascular disease, gastrointestinal dysfunction and very low birth weight. Most complications in newborns are associated with oxidative stress that develops during the early period of growth. The formation of free radicals entails oxidative damage to many organs and systems of the body and is the main factor responsible for the development of typical diseases of preterm infants, such as bronchopulmonary dysplasia, patent ductus arteriosus, retinopathy of prematurity, necrotizing enterocolitis, intraventricular hemorrhage, and respiratory distress syndrome. Premature infants depend on adequate early parenteral nutrition, which not only guarantees they will survive but also ensures positive health outcomes later in life. Early use of intravenous lipids helps to prevent essential fatty acid deficiencies, provides energy and substrates for cell membrane synthesis, which are important for the growth and development of infants with very low and extremely low birth weight. This publication represents data on the effect of intravenous lipids on critical conditions and metabolic disorders in newborns. Literature sources are analyzed and the existing evidence of the possible influence of lipid emulsions on critical diseases in newborns is presented: intraventricular hemorrhage; necrotizing enterocolitis, patent ductus arteriosus and thrombocytopenia; glucose metabolism (hypo- and hyperglycemia); hyperbilirubinemia and chronic liver damage. The literature review is aimed at finding optimal strategies for the use of lipid emulsions in intensive care of newborns to improve the quality of care for premature infants. The purpose of this work is to analyze the results of published studies and systematize data on the feasibility and safety of lipid emulsions used in newborns with critical diseases of the perinatal period.

scholarly journals Antenatal Magnesium Sulfate Exposure and Hemodynamically Significant Patent Ductus Arteriosus in Premature Infants

2019 ◽  
Vol 09 (04) ◽  
pp. e353-e356 ◽  
Author(s):  
Amna Qasim ◽  
Sunil K. Jain ◽  
Ashraf M. Aly
Keyword(s):  
Patent Ductus Arteriosus ◽  
Magnesium Sulfate ◽  
Premature Infants ◽  
Ductus Arteriosus ◽  
Group Analysis ◽  
Matched Group ◽  
Increased Risk ◽  
Significant Difference ◽  
Baseline Characteristics ◽  
Patent Ductus

Abstract Objective The use of antenatal magnesium sulfate (MgSO4) has been associated with neuroprotective effects. One of its' proposed mechanisms of action includes antagonism of calcium channels. Calcium influx is important for closure of ductus arteriosus. We hypothesized that antenatal MgSO4 exposure may be associated with an increased risk of hemodynamically significant patent ductus arteriosus (HsPDA) in premature infants (PI). Study Design A prospective cohort study conducted in two parts. PI (< 32 weeks and < 1,500 g) were recruited (n = 105). All infants had Echocardiograph (ECHO; within 3 days) and blood samples drawn at the same time for B-type natriuretic peptide (BNP; part 1) and NTproBNP (N-terminal pro BNP; part 2) measurements. HsPDA was defined as a PDA diameter > 1.5 mm and BNP levels > 40 pg/mL or NTproBNP > 10,200 pg/mL. Infants were divided into two groups based on antenatal MgSO4 exposure. Data were analyzed using SPSS 23. Difference in baseline characteristics and antenatal steroid use in the two groups was analyzed. A matched group analysis was performed to adjust for the difference in the numbers between the two groups. A p-value < 0.05 was considered significant. Results There was no significant difference seen in baseline characteristics or use of antenatal steroids in exposed versus unexposed (n = 95 vs. n = 10). There was a significant negative correlation between antenatal MgSO4 exposure and HsPDA in PI (p ≤ 0.05). However, this association was not significant after matched group analysis. Conclusion Antenatal MgSO4 exposure is not associated with an increased risk of HsPDA. It may be associated with a decreased likelihood of HsPDA.

Patent Ductus Arteriosus Device Closure in Low Birth Weight Premature Infants: A Single Center Experience

2021 ◽  
Author(s):  
Elizabeth E. LaSalle ◽  
Carolyn M. Wilhelm ◽  
Renelle S. George ◽  
Mohammad Shahnewaz Khan ◽  
Vidhi Shah ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Patent Ductus Arteriosus ◽  
Premature Infants ◽  
Ductus Arteriosus ◽  
Single Center ◽  
Device Closure ◽  
Single Center Experience ◽  
Patent Ductus

Left Ventricular Dysfunction after Closure of Large Patent Ductus Arteriosus

2005 ◽  
Vol 13 (1) ◽  
pp. 24-29 ◽  
Author(s):  
M Omar Galal ◽  
Mohamed Amin ◽  
Arif Hussein ◽  
Amjad Kouatli ◽  
Jameel Al-Ata ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Patent Ductus Arteriosus ◽  
Ductus Arteriosus ◽  
Intervention Group ◽  
Left Ventricular ◽  
Left Ventricular Performance ◽  
Ventricular Performance ◽  
Group A ◽  
Group B ◽  
Patent Ductus

Changes in left ventricular dimensions and performance were studied in 43 patients after transcatheter occlusion or surgical ligation of patent ductus arteriosus. The patients were assigned to 2 groups based on their ductal diameter: ≥ 3.1 mm to group A ( n = 27) and ≤ 3 mm to group B ( n = 16). The mean age and weight of the groups were comparable. Before intervention, group A had a significantly larger mean left ventricular end-diastolic diameter than group B, while all patients had normal shortening fraction and ejection fraction. Within 1 month after intervention, left ventricular end-diastolic diameter showed a trend towards regression while shortening fraction and ejection fraction decreased significantly in group A. There were no significant changes in these parameters in group B. Between 1 and 6 months after intervention, left ventricular performance improved in most of the group A patients who were followed up. We conclude that closure of large ductus arteriosus in children leads to significant immediate deterioration of left ventricular performance, which appears to recover within a few months. Echocardiographic study before hospital discharge is recommended in these patients. Serious deterioration of ventricular performance after closure may warrant the use of angiotensin converting enzyme inhibitors.

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