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ORIGINAL ARTICLE
Korean J Pediatr 2008 October;51(10) :1065-1070.
doi:https://doi.org/10.3345/kjp.2008.51.10.1065
Delayed closure effect in preterm infants with patent ductus arteriosus
Hyun Ju Lee (Lee HJ), Gyu Hong Sim (Sim GH), Kyung Eun Jung (Jung KE), Jin A Lee (Lee JA), Chang Won Choi (Choi CW), Ee Kyung Kim (Kim EK), Han Suk Kim (Kim HS), Beyong Il Kim (Kim BI), Jung-Hwan Choi (Choi JH)
Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
Corresponding Author: Jung-Hwan Choi ,Email: neona@plaza.snu.ac.kr
Copyright © 2008 by The Korean Pediatric Society
ABSTRACT
Purpose : This study aims to determine whether early closure (within 7 d) of significant patent ductus arteriosus (PDA) with indomethacin or ligation reduces neonatal morbidity when compared with delayed closure (after 7 d). Methods : Fifty-eight extremely-low-birth-weight infants admitted to the NICU of Seoul National University Hospital from April 2005 to May 2007 with PDA were studied retrospectively. Results : The mean gestational age (GA) was 262 weeks (range, 23-32 wk), and the birth weight was 782146 g (range, 430-990 g). The delayed closure group was associated with early GA (25.71.7 wk vs. 27.12.0 wk, P=0.013), in vitro fertilization (IVF) (55% vs 24%, P=0.017), and the absence of preeclampsia (5% vs. 34%, P=0.013). There was no difference in ductal size between the early closure and delayed closure groups. The incidence of bronchopulmonary dysplasia (95% vs 65%, P=0.012) and intraventricular hemorrhage (70% vs. 39%, P=0.027) increased in the delayed closure group. Using regression analysis adjusted for gestational age, delayed closure correlated positively with the duration of ventilator support (P=0.008), hospitalization (P=0.020), time to full enteral feeding (P<0.001), and total parenteral nutrition (P=0.010).. Conclusion : Delayed closure of the hemodynamically significant patent ductus arteriosus in extremely-low-birth-weight infants is significantly related to the development of various morbidities. Thus, early closure of PDA is needed within the first week of life.
Keywords: Patent ductus arteriosus | Prematurity | Indomethacin | Surgical procedures | Treatment
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