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Low Rate of Spontaneous Closure in Premature Infants Discharged with a Patent Ductus Arteriosus: A Multicenter Prospective Study.
Tolia, Veeral N; Powers, George C; Kelleher, Amy S; Walker, M Whit; Herrman, Kristy K; Ahmad, Kaashif A; Buchh, Basharat; Egalka, Matthew C; Hinkes, Michael; Ma, Meiyun; Richards, Moira; Rudine, Anthony C; Sato, Ray Y; Shaffer, Kenneth M; Clark, Reese H.
Afiliação
  • Tolia VN; Department of Neonatology, Baylor University Medical Center and Pediatrix Medical Group, Dallas, TX; The MEDNAX Center for Research, Education, Quality and Safety, Sunrise, FL. Electronic address: Veeral.tolia@baylorhealth.edu.
  • Powers GC; Department of Pediatrics, Baylor College of Medicine and Pediatrix Medical Group, San Antonio, TX.
  • Kelleher AS; The MEDNAX Center for Research, Education, Quality and Safety, Sunrise, FL.
  • Walker MW; Greenville Memorial Hospital, Greenville, SC.
  • Herrman KK; Seton Medical Center and Dell Children's Medical Center, Austin, TX.
  • Ahmad KA; Department of Pediatrics, Baylor College of Medicine and Pediatrix Medical Group, San Antonio, TX.
  • Buchh B; Memorial Hospital South Bend, South Bend, IN.
  • Egalka MC; Methodist Children's Hospital, San Antonio, TX.
  • Hinkes M; Northside Hospital, Atlanta, GA.
  • Ma M; Summerlin Hospital Medical Center, Summerlin, NV.
  • Richards M; Tucson Medical Center, Tucson, AZ.
  • Rudine AC; St. David's Medical Center, Austin, TX.
  • Sato RY; Tacoma General Hospital, Tacoma, WA.
  • Shaffer KM; Pediatric and Congenital Cardiology Associates, Texas Center for Pediatric and Congenital Heart Disease, University of Texas - Dell Medical School, Austin, TX.
  • Clark RH; The MEDNAX Center for Research, Education, Quality and Safety, Sunrise, FL; Greenville Memorial Hospital, Greenville, SC.
J Pediatr ; 240: 31-36.e2, 2022 01.
Article em En | MEDLINE | ID: mdl-34293369
OBJECTIVES: To assess the rate of spontaneous closure and the incidence of adverse events in infants discharged home with a patent ductus arteriosus. STUDY DESIGN: In a prospective multicenter study, we enrolled 201 premature infants (gestational age of 23-32 weeks at birth) discharged home with a persistently patent ductus arteriosus (PDA) and followed their PDA status at 6-month intervals through 18 months of age. The primary study outcome was the rate and timing of spontaneous ductal closure. Secondary outcomes included rate of assisted closure and the incidence of serious adverse events. RESULTS: Spontaneous ductal closure occurred in 95 infants (47%) at 12 months and 117 infants (58%) by 18 months. Seventeen infants (8.4%) received assisted closure with surgical ligation or device assisted occlusion. Three infants died (1.5%). Although infants with spontaneous closure had a higher mean birth weight and gestational age compared with infants with a persistent PDA or assisted closure, we did not identify other factors predictive of spontaneous closure. CONCLUSIONS: Spontaneous closure of the PDA occurred in slightly less than one-half of premature infants discharged with a patent ductus by 1 year, lower than prior published reports. The high rate of assisted closure and/or adverse events in this population warrants close surveillance following discharge. TRIAL REGISTRATION: ClinicalTrials.gov: NCT02750228.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Permeabilidade do Canal Arterial Tipo de estudo: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans / Infant / Newborn Idioma: En Revista: J Pediatr Ano de publicação: 2022 Tipo de documento: Article País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Permeabilidade do Canal Arterial Tipo de estudo: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans / Infant / Newborn Idioma: En Revista: J Pediatr Ano de publicação: 2022 Tipo de documento: Article País de publicação: Estados Unidos