Using benchmarking to identify inter-centre differences in persistent ductus arteriosus treatment : can we improve outcome?
| Autor: | Daniel C. Vijlbrief, Peter Andriessen, Richard A. van Lingen, Esther J. S. Jansen, Koen P. Dijkman, Willem B. de Vries, Willem P. de Boode |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
Pediatrics Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] ductal ligation Infant Premature Diseases 0302 clinical medicine newborn Ductus arteriosus 030212 general & internal medicine Ductus Arteriosus Patent Netherlands ibuprofen Incidence (epidemiology) Anti-Inflammatory Agents Non-Steroidal Gestational age General Medicine Ibuprofen Prognosis Perinatology and Child Health Survival Rate Benchmarking medicine.anatomical_structure Echocardiography Gestation Female Cardiology and Cardiovascular Medicine Infant Premature medicine.drug medicine.medical_specialty congenital hereditary and neonatal diseases and abnormalities Birth weight Gestational Age 03 medical and health sciences patent ductus arteriosus indomethacin 030225 pediatrics medicine Journal Article Humans Dosing Pediatrics Perinatology and Child Health Cardiac Surgical Procedures Ligation Retrospective Studies business.industry Ductus arteriosus closure Infant Newborn Infant Low Birth Weight Pediatrics Perinatology and Child Health Morbidity business Follow-Up Studies |
| Zdroj: | Cardiology in the Young, 27(8), 1488. Cambridge University Press Cardiology in the Young, 27, 1488-1496 Cardiology in the Young, 27, 8, pp. 1488-1496 |
| ISSN: | 1047-9511 |
| Popis: | ObjectiveThe aim of this study was to identify inter-centre differences in persistent ductus arteriosus treatment and their related outcomes.Materials and methodsWe carried out a retrospective, multicentre study including infants between 24+0 and 27+6 weeks of gestation in the period between 2010 and 2011. In all centres, echocardiography was used as the standard procedure to diagnose a patent ductus arteriosus and to document ductal closure.ResultsIn total, 367 preterm infants were included. All four participating neonatal ICU had a comparable number of preterm infants; however, differences were observed in the incidence of treatment (33–63%), choice and dosing of medication (ibuprofen or indomethacin), number of pharmacological courses (1–4), and the need for surgical ligation after failure of pharmacological treatment (8–52%). Despite the differences in treatment, we found no difference in short-term morbidity between the centres. Adjusted mortality showed independent risk contribution of gestational age, birth weight, ductal ligation, and perinatal centre.ConclusionsUsing benchmarking as a tool identified inter-centre differences. In these four perinatal centres, the factors that explained the differences in patent ductus arteriosus treatment are quite complex. Timing, choice of medication, and dosing are probably important determinants for successful patent ductus arteriosus closure. |
| Databáze: | OpenAIRE |
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