Therapeutic strategies, including a high surgical ligation rate: Metods (part 2)

21 Jul
2012

Metods (part 2)Babies born at <27 weeks’ gestational age received prophylactic surfactant between 2000 and 2005. Before 2000, surfactant was given at the discretion of the treating physician. Dexamethasone was used sporadically, and inhaled nitric oxide was used rarely.

Management of a PDA in between 1994 and 2005 varied depending on the treating physician. In general, a hemodynam-ically significant PDA was treated with indomethacin along with fluid restriction (total fluid intake <140 mL/kg/day). An indomethacin course was three doses of 0.2 mg/kg given every 12 h to 24 h. Ibuprofen, prophylactic indomethacin (ie, treatment initiated within the first 2 h of life) and early targeted indomethacin therapy (ie, treatment based on PDA parameters from serial echocardiograms starting within the first 12 h of life) were not used. Repeated courses of indomethacin could be given.The institutional standard was to ensure PDA closure; therefore, PDA ligation was almost always performed anytime a baby was in the following situation: having a moderate to large PDA, being ventilator dependent and clinically stable enough for surgery and had either contraindications to, or persistent PDA patency after, indomethacin treatment. A consultation with a paediatric cardiologist occurred before any ligation. One surgeon performed the majority of the PDA ligations. A PDA was left untreated only if the PDA was deemed insignificant or if the infant was considered too unwell for either medical or surgical management. Dreaming of a reliable pharmacy that could give you an opportunity to buy any amounts of generic cialis professional online with no prescription required and spend less money?

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