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

作者：Knott E Marty^*; Zamora Alvaro; Cavett Clinton; Wattsman Terri ann

来源：European Journal of Pediatric Surgery, 2013, 23(4): 270-272.

DOI：10.1055/s-0032-1330842

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

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.

• 出版日期2013-8