Archive for the ‘Therapeutic strategies’ Category

The present study was limited by its retrospective, observational nature, the use of a basic echocardiographical marker for assisting in the determination of PDA significance and the long time period of the study. The exclusion of infants who died in the first seven days of life removed 11 deaths from the nonligation subgroups and could […]

PDA ligation has its place in the management of a PDA, but defining those that need it and when it is best performed remain issues of much debate. In the present population, ligation was associated with a prolonged duration of mechanical ventilation and hospital stay in survivors, but trended toward a decrease in mortality. This […]

Clinical equipoise around the management of PDA in extremely preterm babies prompted the present study. Though the subject has been widely studied, no previous study has focused on the rate of PDA ligation after repeated indomethacin exposure in an extreme preterm population. In our institution, the ligation rate in infants who received more than one […]

Additional results The majority of ligations after failed indomethacin treatment (n=75) were performed due to persistent ventilatory requirements in isolation (n=58). Contraindications to indomethacin (n=13), pulmonary hemorrhage (n=2) and congestive heart failure (n=2) were the other indications for ligation in this group. The early ligation (<14 days) subgroup spent more time on the ventilator (P<0.001) […]

Table 3 shows the demographic data for the two additional subgroups; there were no significant differences in clinical outcomes between them. TABLE 3 Demographics for and comparison between infants treated with one versus two or more courses of indomethacin, among 23+0 to 26+6 weeks’ gestational age infants with a patent ductus arteriosus (PDA) that was […]

Subgroup comparisons Table 2 shows the demographic data for the three subgroups. Survival in the ligation group were significantly associated with a longer duration of mechanical ventilation (P<0.001) and hospital stay (P=0.002). A trend toward lower mortality (P=0.07) was noted in the ligation group. The further indomethacin group had a higher median gestational age, but […]

Of the 196 patients, 80% of the infants had an echocardiogram before any treatment. Seventy-eight per cent had a moderate to large PDA; this percentage rose to 96% in those ligated. All infants with surgical ligation were dependent upon mechanical ventilation at the time of their surgery. There was no significant change in the time […]