| The management of patent ductus arteriosus in Australia and New Zealand. | |
| | |
MedLine Citation:
|
PMID: 19291140 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
AIM: This study aimed to establish current management practice for patent ductus arteriosus (PDA) among individual consultant neonatologists in Australia and New Zealand, to examine the influences that drives practice and highlight the importance of future randomised controlled trials in the region. METHODS: Eligible subjects were identified from the Directory of Neonatal Intensive Care Units in Australia and New Zealand, 2007. A questionnaire was sent online to each consultant and was followed up with a letter and telephone call. Seven questions addressed management approach, the drug used and the treatment regimen, threshold for referral for surgical ligation and the literature influencing practice. Data were collected from 22 August 2007 to 22 November 2007. RESULTS: The overall response rate was 95%. For infants < or =28 weeks or < or =1000 g, all consultants treat PDA by one of four distinct management approaches. Expectant management was favoured by 35%, echocardiographic targeted prophylaxis 32%, presymptomatic treatment 16% and prophylaxis by 17%. There were marked regional variations in practice. Within individual units, more than one approach is used in 14 out of 24 units. Long courses of indomethacin are used to treat PDA by 86%. For 22% of consultants, management is not influenced by published literature. CONCLUSIONS: Differences of opinion in the literature are reflected by the heterogeneity in clinical practice across regions and within units. Crucial questions undergoing evaluation are whether data extrapolated from a previous area are relevant to PDA in modern neonatology and whether targeting treatment early can translate to improved clinical outcome. |
| | |
Authors:
|
Adam B Hoellering; Lucy Cooke |
Publication Detail:
|
Type: Journal Article Date: 2009-03-05 |
Journal Detail:
|
Title: Journal of paediatrics and child health Volume: 45 ISSN: 1440-1754 ISO Abbreviation: J Paediatr Child Health Publication Date: 2009 Apr |
Date Detail:
|
Created Date: 2009-05-11 Completed Date: 2009-10-08 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 9005421 Medline TA: J Paediatr Child Health Country: Australia |
Other Details:
|
Languages: eng Pagination: 204-9 Citation Subset: IM |
Affiliation:
|
Centre for Newborn Care, Westmead Hospital, Westmead, Sydney, New South Wales, Australia. abhoellering@doctors.org.uk |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Australia Cardiovascular Agents / therapeutic use Ductus Arteriosus, Patent / therapy* Humans Indomethacin / therapeutic use Infant, Low Birth Weight Infant, Newborn Infant, Premature Intensive Care, Neonatal / methods*, statistics & numerical data New Zealand Physician's Practice Patterns / statistics & numerical data* Practice Guidelines as Topic Questionnaires |
| Chemical | |
Reg. No./Substance:
|
0/Cardiovascular Agents; 53-86-1/Indomethacin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Genetic mapping of quantitative trait loci for resistance to Haemonchus contortus in sheep.
Next Document: Laboratory tools and strategies for methicillin-resistant Staphylococcus aureus screening, surveilla...