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Eur J Pediatr Surg 2013; 23(04): 270-272
DOI: 10.1055/s-0032-1330842
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Decline in Health Status of Extremely Premature Neonates with Patent Ductus Arteriosus after Second Course of Medical Therapy

E. Marty Knott
1   Department of Surgery, Carilion Clinic, Roanoke, Virginia, United States
,
Alvaro Zamora
1   Department of Surgery, Carilion Clinic, Roanoke, Virginia, United States
,
Clinton Cavett
1   Department of Surgery, Carilion Clinic, Roanoke, Virginia, United States
,
Terri-ann Wattsman
1   Department of Surgery, Carilion Clinic, Roanoke, Virginia, United States
› Author Affiliations
Further Information

Publication History

16 April 2012

24 September 2012

Publication Date:
21 November 2012 (online)

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Abstract

Introduction Many neonatal centers offer surgical ligation of patent ductus arteriosus (PDA) after two failed courses of pharmacologic therapy. This study compares health status of extremely premature (< 28 weeks gestation) neonates who failed medical therapy at the time of their second course of medical treatment versus operation.

Materials and Methods A retrospective chart review was performed on neonates born at less than 28 weeks gestation who underwent PDA ligation after two rounds of medical therapy over a 7.5-year period. Measurements of health status at the time of the second course of medical therapy and the time of operation were compared.

Results Neonates (n = 34) required less fraction of inspired oxygen (33.5 ± 12.9% vs. 48.5 ± 24%, p < 0.0001), had lower mean airway pressure (7.5 ± 1.9 vs. 9.1 ± 2.4 mm Hg, p < 0.0001), and were less likely to require vasopressor support (16.7 vs. 60%, p = 0.0126) at the time of the start of second course than at surgery.

Conclusion Our study suggests that extremely premature neonates show a decline in cardiopulmonary reserve between a second course of medical therapy and surgical intervention.

Keywords

extremely premature - neonate - patent ductus arteriosus - ligation - cardiopulmonary reserve
 

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