Patent ductus arteriosus in infants <29 weeks gestation--outcomes and factors affecting closure.

Content Provider	Semantic Scholar
Author	Popat, Himanshu P. Kapoor, Vishal Travadi, Javeed N.
Copyright Year	2012
Abstract	OBJECTIVE To determine Patent ductus arteriosus (PDA) closure rates for extremely preterm infants in a tertiary care centre, factors affecting response to indomethacin and outcomes of these infants relative to their PDA status. SETTING Neonatal intensive care unit in tertiary-care children's hospital. DESIGN Retrospective medical record review. METHODS A retrospective chart review of all infants <29 weeks gestation between 1st Jan 2003 and 30th June 2006 was carried out. Multiple courses of standard intravenous indomethacin (dose: 0.2 mg/kg 12 hourly; 3 doses) followed by a tail course (0.1 mg/kg/day; 3 doses) were used to treat PDA depending on clinical and hemodynamic status. Data on demographic characteristics, PDA status, use of indomethacin, and outcome factors such as chronic lung disease and mortality were collected. RESULTS A total of 166 infants were identified in the study period, of which 15 were excluded. The median gestation was 27 weeks [IQR (25, 28)] and the mean (SD) birthweight was 950 (244) grams. The remaining infants (n=151) were divided into three groups. Group1 (n=47): no or non-significant PDA, Group 2 (n=91): significant PDA closed after indomethacin treatment (= 1 course) and Group 3 (n=13): significant PDA not responding to indomethacin. The closure rate of PDA with indomethacin treatment (group 2) was 87%. A low gestational age < 26 weeks (OR 5.6, 95% CI 1.6-19.9) and female sex (OR 5.8, 95% CI 1.5-22.8) was associated with poor response to indomethacin in our study population. CONCLUSIONS Multiple indomethacin courses using the standard dosing approach result in high PDA closure rates for infants < 29 weeks gestation.
File Format	PDF HTM / HTML
Alternate Webpage(s)	http://www.indianpediatrics.net/aug2012/615.pdf
Alternate Webpage(s)	https://page-one.live.cf.public.springer.com/pdf/preview/10.1007/s13312-012-0132-3
PubMed reference number	22317982v1
Volume Number	49
Issue Number	8
Journal	Indian pediatrics
Language	English
Access Restriction	Open
Subject Keyword	Birth Weight Chronic lung disease Closure Exclusion Females Indomethacin Infant, Extremely Premature Intensive Care Units, Neonatal Lung diseases Medical Records Neonatal Intensive Care Patent ductus arteriosus Physiological Sexual Disorders Pregnancy Preterm Infant Structure of ductus arteriosus gram mg/kg
Content Type	Text
Resource Type	Patent