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Patent Ductus Arteriosus In Preterm

Carlos Hernández Díaz, Cristina Ruiz Hierro, Marta Ortega Escudero, Jacobo Montero García, Yaiza Galvañ Felix, Sara Martínez Díaz, Joaquin Suárez Fernández
INTRODUCTION: Patent ductus arteriosus (PDA) is considered a risk factor for necrotising enterocolitis (NEC) and other gastrointestinal complications in preterm infants. The aim of this study is to determine whether there is a higher incidence of abdominal surgery and the associated morbidity and mortality in preterm infants who require treatment due to a significant PDA. METHODS: An observational study was conducted that included preterm infants with <37 weeks of gestational age, and a diagnosis of PDA in the last 10 years...
February 15, 2019: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
Se In Sung, Yun Sil Chang, Jisook Kim, Jin Hwa Choi, So Yoon Ahn, Won Soon Park
This study aimed to determine the natural course of patent ductus arteriosus (PDA) with noninterventional conservative management and whether the presence and/or prolonged duration of hemodynamically significant (HS) PDA increased the risk of mortality and morbidities in extremely preterm (EPT) infants. We retrospectively reviewed the medical records of EPT infants born at 23-28 weeks of gestation (n = 195) from January 2011 to June 2014, when PDA was managed with noninterventional conservative treatment. We stratified infants into three subgroups of 23-24, 25-26, and 27-28 weeks and analyzed the prevalence and natural evolution of HS PDA, defined as ventilator dependency and PDA size ≥2 mm...
2019: PloS One
Karl Wilhelm Olsson, Anders Jonzon, Richard Sindelar
AIM: We assessed whether early haemodynamically significant patent ductus arteriosus (hsPDA) predicted persistent PDA in extremely preterm infants. METHODS: This prospective observational study of 60 infants born at 22-27 weeks of gestational age without any major congenital anomalies or heart defects was conducted at Uppsala University Children's Hospital from November 2012 to May 2015. Respiratory and systemic circulatory parameters were continuously recorded and echocardiographic examinations performed daily during the first three days of life...
February 12, 2019: Acta Paediatrica
Batoule Majed, David A Bateman, Natalie Uy, Fangming Lin
BACKGROUND: This study aimed to test the hypothesis that a patent ductus arteriosus (PDA) is independently associated with acute kidney injury (AKI) in neonates ≤ 28 weeks gestation. METHODS: Preterm infants with echocardiographic diagnosis of moderate-large PDA at age ≤ 30 days were studied retrospectively. AKI, the primary outcome, was defined and staged according to serum creatinine using Kidney Disease Improving Global Outcomes (KDIGO) neonatal criteria...
January 31, 2019: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Maarja Hallik, Mari-Liis Ilmoja, Tõnis Tasa, Joseph F Standing, Kalev Takkis, Rūta Veigure, Karin Kipper, Tiiu Jalas, Maila Raidmäe, Karin Uibo, Joel Starkopf, Tuuli Metsvaht
OBJECTIVES: The postoperative course of patent ductus arteriosus ligation is often complicated by postligation cardiac syndrome, occurring in 10-45% of operated infants. Milrinone might prevent profound hemodynamic instability and improve the recovery of cardiac function in this setting. The present study aimed to describe the population pharmacokinetics of milrinone in premature neonates at risk of postligation cardiac syndrome and give dosing recommendations. DESIGN: A prospective single group open-label pharmacokinetics study...
January 18, 2019: Pediatric Critical Care Medicine
Alona Bin-Nun, Yair Kasirer, Francis Mimouni, Irina Schorrs, Daniel Fink, Cathy Hammerman
BACKGROUND AND OBJECTIVES:  Widened pulse pressure is generally associated with patent ductus arteriosus (PDA). Surprisingly, this is often not true for preterm infants during the first week of life when systolic and diastolic pressures are both reduced and pulse pressure may remain unchanged. METHODS:  This is a retrospective, observational review of individual blood pressure (BP) parameters preterm neonates <30 weeks' gestational age during the first week of life as correlated with ductal patency and severity...
January 15, 2019: American Journal of Perinatology
Sonia El-Saiedi, Antoine Fakhry AbdelMassih, Yasser Sedky, Amr Malash, Nouran Hussain, Monica Alfons, Rana Essam
Background: Hemodynamically significant (HS) patent ductus arteriosus (PDA) is a significant cause of mortality in preterm neonates. Early detection of HS PDA and pre-symptomatic closure may help in avoiding complications. For this to happen, easily performed predictors must be available; the aim of this paper is to test the reliability and repeatability of tissue Doppler-derived parameters for prediction of HS PDA. Methods: Preterm neonates <32 weeks were screened with echocardiography at Day 3 of life; 80 neonates with PDA were classified into HS group and hemodynamically insignificant (HIS) group based on benchmark parameter namely left ventricular outflow to superior vena caval flow ratio (LVO/SVC), and a ratio ≥4 was considered predictive of HS PDA...
April 2019: Journal of the Saudi Heart Association
Ruben Vaidya, Donna Wilson, Yvonne Paris, Laura Madore, Rachana Singh
PURPOSE: Patent ductus arteriosus (PDA) continues to be one of the most common complications associated with preterm birth. Up to 70% of infants born before 28 weeks gestational age may require some form of medical or surgical treatment for PDA closure. Recent studies have suggested acetaminophen to be a promising new alternative to indomethacin and ibuprofen for closure of PDA with potentially fewer adverse effects. Our aim for the study was to report our experience regarding the efficacy of acetaminophen compared to indomethacin for treatment of hemodynamically significant PDA (hs-PDA) in infants born in our institution...
January 28, 2019: Journal of Maternal-fetal & Neonatal Medicine
William E Benitz
No abstract text is available yet for this article.
December 11, 2018: Jornal de Pediatria
Jennifer L Shepherd, Shahab Noori
OBJECTIVE: There is no consensus on the definition of a hemodynamically significant patent ductus arteriosus (hsPDA). In this review article, our objective is to discuss the main variables that one should consider when determining the hemodynamic significance of a PDA. RESULTS: We describe the various approaches that have been utilized over time to define an hsPDA and discuss the strengths and weaknesses of each echocardiographic index. Finally, we propose a comprehensive and individualized approach in determining the hemodynamic significance of the PDA...
December 12, 2018: Congenital Heart Disease
Maria Gillam-Krakauer, Jeff Reese
Preterm infants are at increased risk for patent ductus arteriosus (PDA). Prolonged exposure to PDA may be deleterious and has been associated with neonatal morbidity and mortality. Although the molecular mechanisms underlying regulation of postnatal ductus arteriosus closure are not fully understood, clinical experience and research trials have informed recent changes in PDA management strategies and refocused treatment strategies on smaller subsets of infants who require intervention. This review examines current diagnostic and management approaches to PDA in preterm neonates...
July 2018: NeoReviews
Forgive Avorgbedor, Susan Silva, Elizabeth Merwin, James A Blumenthal, Diane Holditch-Davis
OBJECTIVE: To compare the health, physical growth, and developmental outcomes in preterm infants of women with and without hypertensive disorders of pregnancy (HDP). DESIGN: Cross-sectional analysis of health outcomes; physical growth (head circumference, height, and weight) collected at birth and 2 months, corrected for prematurity; and cognitive, language, and motor skills of preterm infants of women with and without HDP. SETTING: Four NICUs in the United States...
January 2019: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
Lisa Molines, Simon Nusinovici, Marie Moreau, Mathilde Remy, Pascale May-Panloup, Cyril Flamant, Jean-Christophe Roze, Patrick Van Bogaert, Pierre-Emmanuel Bouet, Géraldine Gascoin
STUDY QUESTION: Is assisted conception associated with neonatal morbidity and mortality and with neurodevelopmental impairment at 2 years of corrected age in preterm infants born before 34 weeks of gestational age? SUMMARY ANSWER: Assisted conception is not associated with an increase in neonatal morbidity and mortality and is even significantly associated with a better 2-year neurodevelopmental outcome in preterm infants. WHAT IS KNOWN ALREADY: Assisted conception appears to increase the rate of preterm births, though few studies have analysed outcomes for these preterm infants...
February 1, 2019: Human Reproduction
Chen-Hong Wang, Li-Ping Shi, Xiao-Lu Ma, Li-Zhong DU
OBJECTIVE: To study the clinical features and prognosis of bronchopulmonary dysplasia (BPD) complicated by pulmonary hypertension (PH) in preterm infants. METHODS: A retrospective analysis was performed on the clinical data of 191 preterm infants with BPD. RESULTS: In the 191 preterm infants with BPD, 37 (19.4%), all with moderate or severe BPD, developed PH beyond 36 weeks' corrected age. The incidence rates of PH in infants with moderate and severe BPD were 5...
November 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Stacey L Crockett, Courtney D Berger, Elaine L Shelton, Jeff Reese
Regulation of the ductus arteriosus, an essential fetal vessel connecting the pulmonary artery and aorta, is complex. Failure of this vessel to close after birth may result in a persistent left-to-right shunt through the patent ductus arteriosus, a condition associated with significant morbidities. Numerous factors contribute to the shift from fetal ductus patency to postnatal closure, requiring precise coordination of molecular cues with biomechanical forces and underlying genetic influences. Despite significant advances, questions remain regarding signaling dynamics and the natural time course of ductus closure, particularly in preterm neonates...
November 23, 2018: Congenital Heart Disease
Cristina Borràs-Novell, Ana Riverola, Victoria Aldecoa-Bilbao, Montserrat Izquierdo, Monica Domingo, Martín Iriondo
OBJECTIVE: Management of patent ductus arteriosus is still controversial. This study aimed to describe the impact of a more conservative approach on treatment rates and on main outcomes of prematurity, especially in preterm infants with <26 weeks of gestation. METHOD: Clinical charts review of infants ≤30 weeks with patent ductus arteriosus between 2009 and 2016 at two centers. In 2011, the authors changed patent ductus arteriosus management: in first period (2009-2011), patients who failed medical treatment underwent surgical closure; in second period (2012-2016), only those with cardiopulmonary compromise underwent surgical ligation...
November 10, 2018: Jornal de Pediatria
Michele L Shaffer, Olivier Baud, Thierry Lacaze-Masmonteil, Outi M Peltoniemi, Francesco Bonsante, Kristi L Watterberg
OBJECTIVE: To assess the effect of prophylaxis for early adrenal insufficiency using low-dose hydrocortisone on survival without bronchopulmonary dysplasia (BPD) in very preterm infants using an individual patient data meta-analysis. STUDY DESIGN: All existing randomized controlled trials testing the efficacy of the prophylaxis of early adrenal insufficiency using low-dose hydrocortisone on survival without BPD were considered for inclusion when data were available...
November 8, 2018: Journal of Pediatrics
Pankaj Prasun, Raghav Madan, Subhash Puthuraya, Divya Subramanian, Ishita Datta, Vaneet Kalra, Ronald Thomas, David W Stockton, Senthil Sundaram, Joseph Callaghan, Michael Callaghan, Nitin Chouthai
BACKGROUND: The pathophysiology of intraventricular hemorrhage (IVH) is multifactorial. This study attempts to identify genetic and clinical factors contributing to IVH in newborns with a focus on those born ≤28 weeks of gestation. METHODS: This was a prospective study of 382 consecutive newborns admitted to the neonatal intensive care unit. DNA purification was conducted using standard methods. TaqMan SNP assays were conducted for functional polymorphisms in VEGF (RS699947, RS2010963, RS3025039, and RS1570360) and MMP2 (RS243685 and RS2285053) genes...
November 2, 2018: Developmental Neuroscience
Kai-Hsiang Hsu, Pierre Wong, S Ram Kumar, Julie Evans, Shahab Noori
OBJECTIVE: To characterize preterm infants that demonstrates respiratory improvement 7 days after ligation of a patent ductus arteriosus (PDA). STUDY DESIGN: We performed a 2-phase study of preterm infants (birthweight <1500 g between 2010 and 2016). We first did a retrospective analysis using regression modeling of ligation population. We then performed a case-control study comparing a ligation group with infants matched by gestational age, postnatal age, and preligation respiratory condition (ventilator mode, mean airway pressure [MAP], and fraction of inspired oxygen [FiO2 ])...
February 2019: Journal of Pediatrics
Ronald I Clyman, Melissa Liebowitz, Joseph Kaempf, Omer Erdeve, Ali Bulbul, Stellan Håkansson, Johanna Lindqvist, Aijaz Farooqi, Anup Katheria, Jason Sauberan, Jaideep Singh, Kelly Nelson, Andrea Wickremasinghe, Lawrence Dong, Denise C Hassinger, Susan W Aucott, Madoka Hayashi, Anne Marie Heuchan, William A Carey, Matthew Derrick, Erika Fernandez, Meera Sankar, Tina Leone, Jorge Perez, Arturo Serize
OBJECTIVE: To compare early routine pharmacologic treatment of moderate-to-large patent ductus arteriosus (PDA) at the end of week 1 with a conservative approach that requires prespecified respiratory and hemodynamic criteria before treatment can be given. STUDY DESIGN: A total of 202 neonates of <28 weeks of gestation age (mean, 25.8 ± 1.1 weeks) with moderate-to-large PDA shunts were enrolled between age 6 and 14 days (mean, 8.1 ± 2.2 days) into an exploratory randomized controlled trial...
October 16, 2018: Journal of Pediatrics
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