Delayed closure effect in preterm infants with patent ductus arteriosus.
10.3345/kjp.2008.51.10.1065
- Author:
Hyun Ju LEE
1
;
Gyu Hong SIM
;
Kyung Eun JUNG
;
Jin A LEE
;
Chang Won CHOI
;
Ee Kyung KIM
;
Han Suk KIM
;
Beyong Il KIM
;
Jung Hwan CHOI
Author Information
1. Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea. neona@plaza.snu.ac.kr
- Publication Type:Original Article ; In Vitro
- Keywords:
Patent ductus arteriosus;
Prematurity;
Indomethacin;
Surgical procedures;
Treatment
- MeSH:
Birth Weight;
Bronchopulmonary Dysplasia;
Ductus Arteriosus, Patent;
Enteral Nutrition;
Fertilization in Vitro;
Gestational Age;
Hemorrhage;
Hospitalization;
Humans;
Incidence;
Indomethacin;
Infant;
Infant, Newborn;
Infant, Premature;
Ligation;
Parenteral Nutrition, Total;
Pre-Eclampsia;
Ventilators, Mechanical
- From:Korean Journal of Pediatrics
2008;51(10):1065-1070
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: This study aims to determine whether early closure (within 7 d) of significant patent ductus arteriosus (PDA) with indomethacin or ligation reduces neonatal morbidity when compared with delayed closure (after 7 d). METHODS: Fifty-eight extremely-low-birth-weight infants admitted to the NICU of Seoul National University Hospital from April 2005 to May 2007 with PDA were studied retrospectively. RESULTS: The mean gestational age (GA) was 26+/-2 weeks (range, 23-32 wk), and the birth weight was 782+/-146 g (range, 430-990 g). The delayed closure group was associated with early GA (25.7+/-1.7 wk vs. 27.1+/-2.0 wk, P=0.013), in vitro fertilization (IVF) (55% vs 24%, P=0.017), and the absence of preeclampsia (5% vs. 34%, P=0.013). There was no difference in ductal size between the early closure and delayed closure groups. The incidence of bronchopulmonary dysplasia (95% vs 65%, P=0.012) and intraventricular hemorrhage (70% vs. 39%, P=0.027) increased in the delayed closure group. Using regression analysis adjusted for gestational age, delayed closure correlated positively with the duration of ventilator support (P=0.008), hospitalization (P=0.020), time to full enteral feeding (P<0.001), and total parenteral nutrition (P=0.010).. CONCLUSION: Delayed closure of the hemodynamically significant patent ductus arteriosus in extremely-low-birth-weight infants is significantly related to the development of various morbidities. Thus, early closure of PDA is needed within the first week of life.
