Risk factors for the failure of ibuprofen treatment in preterm infants with hemodynamically significant patent ductus arteriosus
10.7499/j.issn.1008-8830.2310145
- VernacularTitle:有血流动力学意义的动脉导管未闭早产儿布洛芬治疗失败的危险因素分析
- Author:
Zi-Qi WU
1
;
Yi ZHANG
;
Qian-Qian ZHOU
;
Qin LIU
;
Shi CHENG
;
Shi-Wen XIA
Author Information
1. 华中科技大学同济医学院附属湖北妇幼保健院新生儿科,湖北武汉 430070
- Keywords:
Patent ductus arteriosus;
Ibuprofen treatment;
Surgical ligation of the ductus arteriosus;
Risk factor;
Preterm infant
- From:
Chinese Journal of Contemporary Pediatrics
2024;26(4):343-349
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the risk factors for the failure of ibuprofen treatment in preterm infants with hemodynamically significant patent ductus arteriosus(hsPDA).Methods A retrospective collection of clinical data was conducted on preterm infants with a gestational age of＜34 weeks who were diagnosed with hsPDA and treated at the Department of Neonatology,Maternal and Child Health Hospital of Hubei Province,Tongji Medical College,Huazhong University of Science and Technology,from January 2018 to June 2023.The subjects were divided into two groups based on the treatment approach:the ibuprofen group(95 cases)and the ibuprofen plus surgery group(44 cases).The risk factors for the failure of ibuprofen treatment in preterm infants with hsPDA were identified by binary logistic regression analysis.Results The binary logistic regression analysis revealed that an increased diameter of the ductus arteriosus,a resistance index(RI)value of the middle cerebral artery ≥0.80,and prolonged total invasive mechanical ventilation time were risk factors for the failure of ibuprofen treatment in preterm infants with hsPDA(P＜0.05).Receiver operating characteristic curve analysis showed that a ductus arteriosus diameter＞2.85 mm,a middle cerebral artery RI value ≥0.80,and a total invasive mechanical ventilation time＞16 days had significant predictive value for the failure of ibuprofen treatment in preterm infants with hsPDA(P＜0.05).The combined predictive value of these three factors was the highest,with an area under the curve of 0.843,a sensitivity of 86.5％,and a specificity of 75.0％(P＜0.05).Conclusions A ductus arteriosus diameter＞2.85 mm,a middle cerebral artery RI value ≥0.80,and a total invasive mechanical ventilation time＞16 days are risk factors for the failure of ibuprofen treatment in preterm infants with hsPDA,and they are of significant predictive value for the necessity of surgical treatment following the failure of ibuprofen treatment.[Chinese Journal of Contemporary Pediatrics,2024,26(4):343-349]
