Outcome following patent ductus arteriosus ligation in premature infants: a retrospective cohort analysisReport as inadecuate




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BMC Pediatrics

, 6:15

First Online: 11 May 2006Received: 20 July 2005Accepted: 11 May 2006

Abstract

BackgroundThe patent ductus arteriosus PDA is an important problem in premature infants. Surgical PDA ligation is usually only be considered when medical treatment has either failed or was contraindicated. The aims of our study were to determine the mortality and morbidity following patent ductus arteriosus ligation in premature infants, and whether prostaglandin synthetase inhibitor PSI use prior to ligation affects outcome.

MethodsA retrospective case note review study to determine the outcome of premature infants undergoing patent ductus arteriosus ligation in one tertiary neonatal intensive care unit and two paediatric cardiothoracic centres.

ResultsWe had follow-up data on 87 infants. Cumulative mortality rates at 7 days, 30 days and at hospital discharge were 2%, 8% and 20% respectively. The incidence of chronic lung disease, intraventricular haemorrhage, necrotising enterocolitis and retinopathy of prematurity were 77%, 39%, 26% and 28% respectively. There was no difference in mortality, incidence of chronic lung disease or duration of oxygen dependence between those who had and those who had not received a PSI prior to surgical ligation. In those who had received 2 or more courses of PSI prior to surgical ligation, there was a trend to increase in the duration of oxygen therapy and chronic lung disease, but no difference in mortality.

ConclusionThis study shows that patent ductus arteriosus ligation is a relatively safe procedure 30 day survival 92% but there is substantial late mortality and a high incidence of morbidity in the survivors. 2 or more courses of PSI prior to surgical ligation trends to increased oxygen dependence and chronic lung disease. This high risk population requires careful follow-up. A definitive prospective cohort study is lacking.

AbbreviationsPDAPatent ductus arteriosus

CLDchronic lung disease

NECnecrotising enterocolitis

IVHintraventricular haemorrhage

ROPretinopathy of prematurity

PSIprostaglandin synthetase inhibitor

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2431-6-15 contains supplementary material, which is available to authorized users.

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Author: LLeona CL Lee - Angela Tillett - Robert Tulloh - Robert Yates - Wilf Kelsall

Source: https://link.springer.com/







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