Is surgical ligation of a patent ductus arteriosus the preferred initial approach for the neonate with extremely low birth weight?

Autor: Robie DK; Section of Pediatric Surgery, Cora and Webb Mading Department of Surgery, Texas Children's Hospital, Houston 77030, USA., Waltrip T, Garcia-Prats JA, Pokorny WJ, Jaksic T
Jazyk: angličtina
Zdroj: Journal of pediatric surgery [J Pediatr Surg] 1996 Aug; Vol. 31 (8), pp. 1134-7.
DOI: 10.1016/s0022-3468(96)90102-5
Abstrakt: The optimal approach to a patent ductus arteriosus (PDA) in an extremely low birth weight (ELBW) neonate, whether initial surgical ligation or a trial of indomethacin, has not been established. The authors reviewed the records of 82 ELBW premature infants who had surgical ligation of a PDA during a 2-year period. Thirty-one received indomethacin before ligation. Bronchopulmonary dysplasia (BPD) occurred in 33% of the infants. Predictors of BPD were prolonged positive pressure ventilation, severe intraventricular hemorrhage (IVH) and lower birth weight (BW). Seventy-seven percent of the infants survived. Predictors of mortality were severe IVH, lower BW, and the occurrence of necrotizing enterocolitis (NEC). The indomethacin-treated infants had a lower incidence of NEC and IVH. Overall, 16% of the patients had perioperative morbidity, and 10% of the patients died. The study shows that a trial of indomethacin therapy is not associated with increased complications in ELBW infants with PDA.
Databáze: MEDLINE
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