Therapeutic strategies, including a high surgical ligation rate: RESULTS (part 3)

26 Jul
2012

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 this is likely not clinically significant. There were no significant differences between these subgroups in the other clinical outcomes.

TABLE 2 Demographics for and comparison among three treatment subgroups, for 23+0 to 26+6 weeks’ gestational :ge infants with : patent duitus arteriosus (PDA) that did not close after one course of indomethacin All you need to discover how safe and advantageous it can be to purchase discount levitra online over the internet is visit the pharmacy suggested and enjoy your shopping experience as well as your treatment.

CharacteristicOne course of indomethacin followed by no further treatment (n=26)One or more courses of indomethacin followed by ligation* (n=75)One course of indo-methacin followed by further course(s) but no ligation (n=32)P
Birth weight, g, median (range)770 (500-1145)760 (491-1134)816 (355-1057)0.515
Gestational age, weeks, median (range)25 (23-26)25 (23-26)25 (24-26)0.035 (subgroup C>B)
Female15 (58)35 (47)17 (53)0.587
Antenatal steroids*16/24 (67)*42/69 (61)*19/28 (68)*0.764
Respiratory distress syndrome§22/26 (85)*68 (91)29 (91)0.685
Small for gestational age0 (0)1 (1)1 (3)0.685
Inotropes^2 (8)27/73 (37)*5 (16)0.003
Age at diagnosis of PDA, days, median (range)4 (1-13)5 (2-19)4 (1-11)0.141
Age at first treatment of PDA, days, median (range)6 (2-22)5 (2-19)5 (2-11)0.304
Sepsis**21 (81)49/74 (66)*18 (56)0.153
Severe intraventricular hemorrhage**5 (19)9/73 (12)*4 (13)0.660
Mortality10/25 (40)*13/73 (18)*9 (28)0.073
Home on oxygen4/14 (29)*22/47 (47)*4/21 (19)*0.084
Necrotizing enterocolitis**4 (15)16/73 (22)*3 (9)0.285
Severe renal dysfunction§§1 (4)14 (19)4 (13)0.187
Retinopathy of prematurity ^6/15 (40)*27/54 (50)*5/22 (23)*0.080
Chronic lung disease***11/14 (79)*44/54 (81)*13/22 (59)*0.124
Time on mechanical ventilator for survivors29 (12-58); n=1539 (9-85); n=59***29 (1-148); n=23<0.001 (subgroup B>A,
days, median (range)and B>C)
Time to discharge for survivors,92 (67-158); n=15115 (58-420); n=52***93 (50-228); n=22***0.002 (subgroup B>A,
days, median (range)and B>C)
PDA failed to close by time of death or discharge14/24 (58)*1 (1)14 (44)<0.001

*Data given as n (%), unless otherwise indicated.* All PDA ligations were performed on mechanically ventilated infants with a hemodynamically significant PDA based on clinical status, echocardiogram findings and cardiology consultation; fTwo doses of betamethasone 12 h to 24 h apart before delivery; tThe denominator reflects the number of infants for whom the outcome was possible, those lost to follow-up and those where the information was not documented; § Received surfactant; HUsed for hypotension and/or myocardial dysfunction considered related to PDA; **Blood culture proven; Grade 3 or 4 intraventricular hemorrhage; §§Modified Bell criteria stage 2A or greater; tt Serum creatinine levels >150 ymol/L, and/or a urine output <0.6 mL/kg/h for >12 h; HHThreshold or prethreshold disease requiring laser surgery (>31 weeks’ corrected gestational age); ***Radiological changes with oxygen requirements or invasive or noninvasive ventilation at >36 weeks’ corrected gestational age; fffLess than expected ‘n’ due to those lost to follow-up and those where the necessary information was not documented

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