Patent ductus arteriosus in preterm infants: benefits of early surgical closure
| Autor: | Tsvetomir Loukanov, Matthias Gorenflo, Stanimir G Georgiev, Elizabeth Fonseca |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male medicine.medical_specialty Time Factors Gestational Age Pharmacological treatment Time-to-Treatment Postoperative Complications Ductus arteriosus Medicine Birth Weight Humans Infant Very Low Birth Weight Cardiac Surgical Procedures Ductus Arteriosus Patent Ligation Retrospective Studies business.industry Infant Newborn Gestational age General Medicine Length of Stay Surgery medicine.anatomical_structure Treatment Outcome Anesthesia Infant Extremely Premature Female Cardiology and Cardiovascular Medicine business Infant Premature |
| Zdroj: | Asian cardiovascularthoracic annals. 22(4) |
| ISSN: | 1816-5370 |
| Popis: | Background Patent ductus arteriosus in preterm neonates leads to significant morbidity. Surgery is indicated when pharmacological treatment fails or is contraindicated, but the optimal timing remains unclear. Methods We retrospectively studied all 41 preterm neonates with symptomatic ductus arteriosus who underwent ligation between 1988 and 2009. We compared early complications rates and late neurological outcomes of patients operated on before 21 days of age with these operated on later. Results The median gestational age at birth was 26 weeks (range 23–31 weeks) and median weight at birth was 930 g (range 510–1500 g); 34 (82.9%) received pharmacological treatment before surgery. Fourteen (34.1%) patients underwent surgical closure before 21 days of age and 27 (65.9%) after 21 days. The 2 groups did not differ significantly in gestational age and weight at birth, but those operated on after 21 days received significantly more pharmacological treatment cycles. Patients in the early closure group had shorter intubation times: median 23 days (range 13–35 days) vs. 43 days (range 27–84 days; p Discussion Performing early ligation of symptomatic ductus arteriosus after unsuccessful pharmacological therapy in preterm neonates might lower complication rates and improve neurological outcome. Prospective randomized studies are needed to determine the optimal treatment. |
| Databáze: | OpenAIRE |
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