Cardiovascular Dysfunction Scoring System Based Ibuprofen Treatment for Patent Ductus Arteriosus in Preterm Infants: A Retrospective Cohort Study in a Leading Chinese Center

2020 ◽  
Author(s):  
Jia Chen ◽  
Hao Liu ◽  
Jinghua Luo ◽  
Yufang Lin ◽  
Shan Zhang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Patent Ductus Arteriosus ◽  
Preterm Infants ◽  
Retrospective Cohort Study ◽  
Scoring System ◽  
Retrospective Cohort ◽  
Ductus Arteriosus ◽  
Cardiovascular Dysfunction ◽  
Patent Ductus

Pulmonary Hemorrhage Risk in Infants With a Clinically Diagnosed Patent Ductus Arteriosus: A Retrospective Cohort Study

PEDIATRICS ◽  
1994 ◽  
Vol 94 (5) ◽  
pp. 719-723 ◽  
Author(s):  
Jeffery Garland ◽  
Rosanne Buck ◽  
Michelle Weinberg
Keyword(s):  
Cohort Study ◽  
Patent Ductus Arteriosus ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Ductus Arteriosus ◽  
Ventilatory Support ◽  
Pulmonary Hemorrhage ◽  
Surfactant Therapy ◽  
Artificial Surfactant ◽  
Patent Ductus

Objective. To determine if an early, dinically detectable patent ductus arteriosus (FDA) was associated with pulmonary hemorrhage (PH) in infants who received rescue artificial surfactant therapy. Methods. This retrospective cohort study of 233 low birth weight infants (≤ 1700 g) who received artificial surfactant therapy for respiratory distress syndrome compared antenatal and postnatal characteristics of infants with PH and without PH. Pulmonary hemorrhage was defined by an onset of bright red blood from the endotracheal tube in quantities that resulted in increased ventilatory support and a new infiltrate on a chest radiograph. Results. Pulmonary hemorrhage occurred in 6% (15/233) of the infants. Thirty-three percent (5/15) of the infants with PH died within 14 days of the hemorrhage. Of the 15 PH, 73% occurred within 48 hours of the first surfactant dose. Pulmonary hemorrhage was more common in male infants and infants of mothers who received antibiotic therapy during labor (P ≤ .04). Infants with PH received surfactant earlier than those without PH (P = .04). Nursery events or therapies occurring following surfactant therapy that were associated with PH included: little improvement in ventilatory efficiency index (P = .01), dopamine infusion (P = .04), and the presence of a clinically detectable PDA before, or at the time of, the PH [60% (9/15) vs 33% (71/217), P = .03]. After adjusting for severity of illness before surfactant therapy, risk of PH remained greater in infants who developed symptoms of a PDA. Dopamine support appeared to modify the association between PDA and PH. Conclusions. In this retrospective cohort study, pulmonary hemorrhage was associated with the presence of a clinically detectable patent ductus arteriosus before, or at the time of, pulmonary hemorrhage.

scholarly journals Ibuprofen treatment for patent ductus arteriosus in preterm infants: a retrospective cohort study in a leading Chinese center

2021 ◽  
Vol 1 (2) ◽  
pp. 103-110
Author(s):  
Jia Chen ◽  
Jinghua Luo ◽  
Hao Liu ◽  
Xue Du ◽  
Shan Zhang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Treatment Group ◽  
Patent Ductus Arteriosus ◽  
Preterm Infants ◽  
Intraventricular Hemorrhage ◽  
Retrospective Cohort ◽  
Ductus Arteriosus ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Patent Ductus

Abstract Objective There is a dilemma of ibuprofen treatment with patent ductus arteriosus (PDA) as to how and when to treat. We aimed to clarify this issue in very preterm infants (VPIs; < 32 weeks). Methods This retrospective study included 1 659 VPIs who were diagnosed with PDA according to echocardiographic examinations and cardiovascular dysfunction scoring system (the CVD scoring). The VPIs were classified into six groups (A1, A2, A3, B1, B2, and B3) based on CVD scores (A, < 3, and B, ≥ 3), and treatment with ibuprofen for PDA (1, conservational management; 2, early ibuprofen treatment; and 3, late ibuprofen treatment). Treatment was stopped when PDA was closed, CVD score was zero or PDA needed ligation. Results VPIs with CVD scores < 3 had most PDA closure without surgery, and early ibuprofen treatment did not significantly affect PDA closure. VPIs with CVD scores ≥ 3 had some PDA closure after 2 courses of treatment, but closure rates decreased linearly with ibuprofen course (1st 75.2%, 2nd 62.3%, 3rd 50.0%, P < 0.0001), and early ibuprofen treatment (group B2) did not increase PDA closure compared to late ibuprofen treatment (group B3). In these same infants, the longer they were in CVD scores ≥ 3, the more the complications of preterm were increased (retinopathy of prematurity ROP 1st 16.5%, 2nd 23.8%, 3rd 29.6%, P = 0.016; bronchopulmonary dysplasia BPD 1st 15.5%, 2nd 26.7%, 3rd 33.8%, P < 0.0001; intraventricular hemorrhage IVH 1st 20.4%, 2nd 32.4%, 3rd 23.8%, P = 0.015). Conclusion Ibuprofen is suggested for PDA closure when the PDA reopens or has developed into the stage when the CVD score ≥ 3.

scholarly journals Effectiveness of Injectable Ibuprofen Salts and Indomethacin to Treat Patent Ductus Arteriosus in Preterm Infants: Observational Cohort Study

2018 ◽  
Vol 71 (1) ◽  
Author(s):  
Deonne Dersch-Mills ◽  
Belal Alshaikh ◽  
Amuchou S Soraisham ◽  
Albert Akierman ◽  
Kamran Yusuf
Keyword(s):  
Cohort Study ◽  
Adverse Effects ◽  
Patent Ductus Arteriosus ◽  
Preterm Infants ◽  
Ductus Arteriosus ◽  
Observational Cohort Study ◽  
End Points ◽  
Surgical Ligation ◽  
Observational Cohort ◽  
Patent Ductus

<p><strong>ABSTRACT</strong></p><p><strong>Background: </strong>There is no injectable ibuprofen product marketed to treat patent ductus arteriosus (PDA) in newborns in Canada. The authors’ institution has used ibuprofen arginine in the past. In the absence of published evidence supporting use of this salt form of ibuprofen for neonatal PDA, a retrospective analysis was undertaken.</p><p><strong>Objective: </strong>To compare the effectiveness and adverse effects of ibuprofen arginine, ibuprofen tromethamine, and indomethacin in the treatment of PDA.</p><p><strong>Methods: </strong>This retrospective observational cohort study, for patients admitted between 2009 and 2015, included preterm infants with symptomatic PDA who received at least one dose of injectable indomethacin, ibuprofen tromethamine, or ibuprofen arginine. Three effectiveness end points were analyzed: closure after one course of treatment, repeat medical treatment, and surgical ligation. The secondary end points included acute kidney injury, necrotizing enterocolitis, chronic lung disease, and time to full enteral feeding.</p><p><strong>Results: </strong>A total of 179 infants were included. There were no differences among groups in terms of closure after one course of treatment (37/54 [69%] with indomethacin, 42/70 [60%] with ibuprofen tromethamine, and 28/55 [51%] with ibuprofen arginine; <em>p </em>= 0.21) or surgical ligation (10/54 [19%] with indomethacin, 13/70 [19%] with ibuprofen tromethamine, and 12/55 [22%] with ibuprofen arginine; <em>p </em>= 0.88). However, there was a difference regarding use of a repeat course of treatment, ibuprofen arginine having the highest rate (8/54 [15%] with indomethacin, 18/70 [26%] with ibuprofen tromethamine, and 20/55 [36%] with ibuprofen arginine; <em>p </em>= 0.04). After adjustment for gestational age, the association between ibuprofen arginine and increased use of a repeat course of treatment remained significant. The groups did not differ with respect to adverse effects.</p><p><strong>Conclusion: </strong>These results highlight the potential for differences in effectiveness among various salt forms of injectable ibuprofen and indomethacin. Because of the small sample size and retrospective methodology, confirmation of the present results through a larger prospective study is needed.</p><p><strong>RÉSUMÉ</strong></p><p><strong>Contexte : </strong>Il n’y a pas sur le marché de produit injectable à base d’ibuprofène pour traiter la persistance du canal artériel (PCA) chez le nouveau-né au Canada. L’ibuprofène arginine a été utilisé auparavant dans l’établissement de santé des auteurs. En l’absence de données publiées appuyant l’utilisation de ce médicament sous forme de ce sel pour traiter la PCA chez le nouveau-né, une analyse rétrospective a été réalisée.</p><p><strong>Objectif : </strong>Comparer l’efficacité et les effets indésirables de l’ibuprofène arginine, de l’ibuprofène trométhamine et de l’indométhacine dans le traitement de la PCA.</p><p><strong>Méthodes : </strong>Cette étude de cohorte observationnelle rétrospective, au sujet de patients hospitalisés entre 2009 et 2015, incluait des nourrissons prématurés atteints d’une PCA symptomatique ayant reçu par injection au moins une dose d’indométhacine, d’ibuprofène trométhamine ou d’ibuprofène arginine. Trois paramètres d’évaluation de l’efficacité ont été analysés : la fermeture après un seul traitement, la répétition du traitement médical et la ligature chirurgicale. Les paramètres d’évaluation secondaires étaient les cas d’insuffisance rénale aiguë, d’entérocolite nécrosante et de maladie pulmonaire chronique ainsi que le temps pour atteindre l’alimentation entérale complète.</p><p><strong>Résultats : </strong>Au total, 179 nourrissons ont été admis à l’étude. Aucune différence n’a été relevée entre les groupes en ce qui touche à la fermeture après un seul traitement (37/54 [69 %] pour l’indométhacine, 42/70 [60 %] pour l’ibuprofène trométhamine et 28/55 [51 %] pour l’ibuprofène arginine; <em>p </em>= 0,21) ou à la ligature chirurgicale (10/54 [19 %] pour l’indométhacine, 13/70 [19 %] pour l’ibuprofène trométhamine et 12/55 [22 %] pour l’ibuprofène arginine; <em>p </em>= 0,88). Cependant, une différence a été observée pour ce qui est de la répétition du traitement et l’ibuprofène arginine a obtenu le taux le plus élevé (8/54 [15 %] pour l’indométhacine, 18/70 [26 %] pour l’ibuprofène trométhamine et 20/55 [36 %] pour l’ibuprofène arginine; <em>p </em>= 0,04). Après ajustement pour l’âge gestationnel, l’association entre l’utilisation de l’ibuprofène arginine et une augmentation du recours à un second traitement demeurait significative. Il n’y avait pas de différence entre les groupes en ce qui touche aux effets indésirables.</p><p><strong>Conclusion : </strong>Ces résultats soulignent la possible différence d’efficacité parmi les divers sels d’ibuprofène injectable et l’indométhacine. Cependant, en raison de la petite taille de l’échantillon et de l’emploi d’une méthodologie rétrospective, une étude prospective plus importante doit être menée pour confirmer les résultats de la présente étude.</p>

Morbidities associated with patent ductus arteriosus in preterm infants. Nationwide cohort study

2017 ◽  
Vol 31 (19) ◽  
pp. 2576-2583 ◽  
Author(s):  
Pia Härkin ◽  
Riitta Marttila ◽  
Tytti Pokka ◽  
Timo Saarela ◽  
Mikko Hallman
Keyword(s):  
Cohort Study ◽  
Patent Ductus Arteriosus ◽  
Preterm Infants ◽  
Ductus Arteriosus ◽  
Patent Ductus

Do Calcium and Potassium Levels Influence Ductal Patency in Preterm Infants?

2019 ◽  
Vol 37 (11) ◽  
pp. 1123-1129 ◽  
Author(s):  
Ufuk Cakir ◽  
Cuneyt Tayman ◽  
Mehmet Buyuktiryaki ◽  
Handan Unsal ◽  
Buse Ozer Bekmez
Keyword(s):  
Cohort Study ◽  
Birth Weight ◽  
Patent Ductus Arteriosus ◽  
Serum Potassium ◽  
Retrospective Cohort ◽  
Ductus Arteriosus ◽  
The Difference ◽  
Relationship Of ◽  
The Relationship ◽  
Patent Ductus

Abstract Objective We investigated the relationship of serum potassium (K+) and ionized calcium (iCa2+) levels with the persistence of ductus arteriosus. Study Design This retrospective cohort study included infants with birth weight < 1,500 g and gestational age < 32 weeks. Serum K+ and iCa2+ levels at the 1st and 48th hour of life were measured from samples. The difference between the two levels was calculated for both serum K+ (ΔK+) and iCa2+ (ΔCa2+). These values were compared between hemodynamically significant patent ductus arteriosus (hsPDA) and non-hsPDA. Results Of 1,322 hospitalized preterm nonates, 1,196 were included in the study. Mean serum K+ levels at the 1st and 48th hour were higher and iCa2+ levels at the 1st and 48th hour were lower in hsPDA and non-hsPDA, respectively (p < 0.001). Ionized ΔCa2+ (–0.06 ± 0.13 vs. –0.02 ± 0.12 mmol/L) was higher in hsPDA (p < 0.001). Conclusion We demonstrated that serum K+ and iCa2+ level might play a role in ductal constriction.

Patent Ductus Arteriosus Treatment in Very Preterm Infants: A European Population-Based Cohort Study (EPICE) on Variation and Outcomes

Neonatology ◽  
2017 ◽  
Vol 111 (4) ◽  
pp. 367-375 ◽  
Author(s):  
Anna-Karin Edstedt Bonamy ◽  
Anna Gudmundsdottir ◽  
Rolf F. Maier ◽  
Liis Toome ◽  
Jennifer Zeitlin ◽  
...  
Keyword(s):  
Cohort Study ◽  
Patent Ductus Arteriosus ◽  
Preterm Infants ◽  
Ductus Arteriosus ◽  
Population Based ◽  
European Population ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Patent Ductus
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