Comparison of the Mortality and In-Hospital Outcomes of Preterm Infants Treated with Ibuprofen for Patent Ductus Arteriosus with or without Clinical Symptoms Attributable to the Patent Ductus Arteriosus at the Time of Ibuprofen Treatment.
10.3346/jkms.2017.32.1.115
- Author:
Hani YOO
1
;
Jin A LEE
;
Sohee OH
;
Young Hwa JUNG
;
Jin A SOHN
;
Seung Han SHIN
;
Chang Won CHOI
;
Ee Kyung KIM
;
Han Suk KIM
;
Beyong Il KIM
Author Information
1. Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea. ljinna@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Patent Ductus Arteriosus;
Premature Infants;
Treatment;
Ibuprofen;
Patient Outcome Assessment
- MeSH:
Bronchopulmonary Dysplasia;
Ductus Arteriosus, Patent*;
Enterocolitis, Necrotizing;
Hemorrhage;
Humans;
Hypotension;
Ibuprofen*;
Incidence;
Infant;
Infant, Newborn;
Infant, Premature*;
Ligation;
Logistic Models;
Mortality*;
Oliguria;
Parturition;
Patient Outcome Assessment;
Pregnancy;
Ventilators, Mechanical
- From:Journal of Korean Medical Science
2017;32(1):115-123
- CountryRepublic of Korea
- Language:English
-
Abstract:
The aim of this study was to assess the differences in the mortality and in-hospital outcomes of preterm infants with < 28 weeks of gestation who received ibuprofen treatment according to the presence of clinical symptoms (any of oliguria, hypotension, or moderate to severe respiratory difficulty) attributable to hemodynamically-significant patent ductus arteriosus (hsPDA) at the time of first ibuprofen treatment. In total, 91 infants born from April 2010 to March 2015 were included. Fourteen infants (15.4%) received ibuprofen treatment when there were clinical symptoms due to hsPDA (clinical symptoms group). In clinical symptoms group, infants were younger (25 [23–27] vs. 26 [23–27] weeks; P = 0.012) and lighter (655 [500–930] vs. 880 [370–1,780] grams; P < 0.001). Also, the clinical risk index for babies (CRIB)-II scores were higher and more infants received invasive ventilator care ≤ 2 postnatal days. More infants received multiple courses of ibuprofen in clinical symptoms group. Although the frequency of secondary patent ductus arteriosus (PDA) ligation and the incidence of bronchopulmonary dysplasia (BPD) was higher in the clinical symptoms group in the univariate analysis, after multivariate logistic regression analysis adjusting for the CRIB-II score, birthweight, birth year, and the invasive ventilator care ≤ 2 postnatal days, there were no significant differences in mortality, frequency of secondary ligation and in-hospital outcomes including necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH), BPD or death. Our data suggest that we can hold off on PDA treatment until the clinical symptoms become prominent.
