Abstract
Cyclooxygenase inhibitors (CI) are widely accepted treatment for hemodynamically significant persistant ductus arteriosus (HsPDA) of the preterm infant (PI) Failure of medical closure of PDA is associated with more complications.
Objective: Analyze the effect of PDA diameter on medical treatment success in PI.
Methods: retrospective study of very PI (≤32 GW) admitted with respiratory distress requiring mechanical ventilation in the first 24 hours of life with a diagnosed HsPDA Failure of treatment was defined by persistance of HsPDA after complete course of CI treatment.
Results: among 217 PI, 54 patients (25%) were diagnosed with hemodynamically significant PDA Five patients died before CI treatment and 49 PI were treated 12 patients (25%) had failed to medical treatment, 4 of them had a chirurgical ligation, 6 died with a significant PDA and 2 were discharged with a pauci-symptomatic PDA Mean anterior PDA diameter in the Fail group (3,1 mm ± 1,1) was higher than that in the Success group (2,3 mm± 1,2; p:0,001) When using an index of PDA diameter/birth weight, a cuttoff value of less than 2,8 mm/kg predicts medical PDA closure in 81% of patients Others risks factors associated with failure treatment were low gestational age and postnatal age ≥ 72 hours at initiation of treatment.
Conclusion: In preterm infants with HsPDA, mean anterior PDA diameter reported to the birth weight > 2,8mm/kg predict failure of medical treatment Delay of CI treatment and low gestational age are also a great risk factors for failure of medical management of PDA.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Khaldi, A., Bouziri, A., Hamdi, A. et al. 646 Impact of Ductal Size on Successful Medical Closure of Patent Ductus Arteriosus in Preterm Infants. Pediatr Res 68 (Suppl 1), 330 (2010). https://doi.org/10.1203/00006450-201011001-00646
Issue Date:
DOI: https://doi.org/10.1203/00006450-201011001-00646