Document Detail


Symptomatic patent ductus arteriosus in very low birth weight infants.
MedLine Citation:
PMID:  9532871     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Premature neonatal survival rates have increased significantly. The diagnosis of patent ductus arteriosus (PDA) has also increased. In this paper, we present our experience of incidence, clinical features and outcome of the treatment of symptomatic PDA in very low birth weight infants. METHODS: From January 1990 to December 1995, 181 premature infants with birth weight less than 1,500 g were admitted to the Neonatal Intensive Care Unit (NICU) of Veterans General Hospital-Taipei. Thirty-seven were diagnosed to have symptomatic PDA. By reviewing hospital records, the clinical features and outcome of treatment of these infants were analyzed retrospectively. RESULTS: The incidence of symptomatic PDA was 20.9% and 21.4% in infants with birth weight less than or equal to 1,000 g, 1,001-1,500 g, respectively. The mean age at diagnosis of infants with symptomatic PDA was significantly less than those without symptoms (3.6 +/- 2.9 days vs 9.6 +/- 17.2 days, p = 0.044, 95% CI = 0.2-11.8). With fluid restriction and diuretic therapy, asymptomatic patients had a higher spontaneous ductal closure rate than symptomatic patients (58.3% vs 10.8%, p < 0.001, 95% CI = 17.9-77.1%). Thirty-two (97.0%) infants with symptomatic PDA responded to indomethacin therapy. However, four infants (12.1%) had recurrence. These four infants and a nonresponder received surgical ligation of the PDA and survived. There were four deaths. The reasons for death were respiratory failure in two, sepsis in one and necrotizing enterocolitis with intestinal perforation in one. CONCLUSIONS: Conservative medical management such as fluid restriction and diuretics are often adequate for asymptomatic PDA. However, since symptomatic PDA tends not to close spontaneously, patients should be treated with indomethacin if ductal shunting compromises cardiopulmonary function.
Authors:
C S Lee; B Hwang; J H Lu; W J Soong; S J Chen
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Zhonghua yi xue za zhi = Chinese medical journal; Free China ed     Volume:  61     ISSN:  0578-1337     ISO Abbreviation:  Zhonghua Yi Xue Za Zhi (Taipei)     Publication Date:  1998 Feb 
Date Detail:
Created Date:  1998-06-25     Completed Date:  1998-06-25     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0005327     Medline TA:  Zhonghua Yi Xue Za Zhi (Taipei)     Country:  TAIWAN    
Other Details:
Languages:  eng     Pagination:  93-8     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, Veterans General Hospital-Taipei, Taiwan, ROC.
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MeSH Terms
Descriptor/Qualifier:
Ductus Arteriosus, Patent / epidemiology,  therapy*
Humans
Incidence
Indomethacin / therapeutic use
Infant, Newborn
Infant, Very Low Birth Weight*
Retrospective Studies
Chemical
Reg. No./Substance:
53-86-1/Indomethacin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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