Effects of therapeutic approach on the neonatal evolution of very low birth weight infants with patent ductus arteriosus

被引：0

作者：

Sadeck, Lilian S. R. ^{[1
]}

Leone, Clea R. ^{[2
]}

Procianoy, Renato S. ^{[3
]}

Guinsburg, Ruth ^{[2
]}

Marba, Sergio T. M. ^{[4
]}

Martinez, Francisco E. ^{[5
]}

Rugolo, Ligia M. S. S. ^{[6
]}

Moreira, M. Elisabeth L. ^{[7
]}

Fiori, Renato M. ^{[8
]}

Ferrari, Ligia L. ^{[9
]}

Menezes, Jucille A. ^{[10
]}

Venzon, Paulyne S. ^{[11
]}

Abdallah, Vania Q. S. ^{[12
]}

Duarte, Jose Luiz M. B. ^{[13
]}

Nunes, Marynea V. ^{[14
]}

Anchieta, Leni M. ^{[15
]}

Alves Filho, Navantino ^{[16
]}

机构：

[1] Univ Sao Paulo, Fac Med, Sao Paulo, SP, Brazil

[2] Univ Sao Paulo, Fac Med, Dept Pediat, Sao Paulo, SP, Brazil

[3] Univ Fed Rio Grande do Sul, Fac Med, Dept Pediat & Child Care, Porto Alegre, RS, Brazil

[4] Univ Estadual Campinas UNICAMP, Fac Ciencias Med, Dept Pediat, Campinas, SP, Brazil

[5] Univ Sao Paulo, Fac Med Ribeirao Preto, Dept Pediat, Ribeirao Preto, SP, Brazil

[6] Univ Estadual Paulista UNESP, Fac Med Botucatu, Dept Pediat, Botucatu, SP, Brazil

[7] Fundacao Oswaldo Cruz FIOCRUZ, Inst Fernandes Figueira, Dept Neonatol, Rio De Janeiro, RJ, Brazil

[8] Pontificia Univ Catolica Rio Grande do Sul PUC RS, Fac Med, Dept Pediat, Porto Alegre, RS, Brazil

[9] Univ Estadual Londrina, Fac Med, Londrina, PR, Brazil

[10] Inst Med Integral Prof Fernando Figueira, Recife, PE, Brazil

[11] Univ Fed Parana UFPR, Dept Pediat, Curitiba, PR, Brazil

[12] Univ Fed Uberlandia, Uberlandia, MG, Brazil

[13] Univ Estadual Rio de Janeiro UERJ, Rio De Janeiro, RJ, Brazil

[14] Univ Fed Maranhao UFMA, Sao Luis, MA, Brazil

[15] Univ Fed Minas Gerais, Belo Horizonte, MG, Brazil

[16] Fac Ciencias Med Minas Gerais CMMG, Belo Horizonte, MG, Brazil

来源：

REVISTA CHILENA DE PEDIATRIA-CHILE | 2016年 / 87卷 / 03期

关键词：

Preterm; Very low birth weight; Ligation; Patent ductus arteriosus managem;

D O I：

10.1016/j.rchipe.2014.04.001

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

Objective: To analyze the effects of treatment approach on the outcomes of newborns (birthweight [ BW] <1000 g) with patent ductus arteriosus (PDA), from the Brazilian Neonatal Research Network (BNRN) on: death, bronchopulmonary dysplasia (BPD), severe intraventricular hemorrhage (IVH III/IV), retinopathy of prematurity requiring surgical (ROPsur), necrotizing enterocolitis requiring surgery (NECsur), and death/BPD. Methods: This was a multicentric, cohort study, retrospective data collection, including newborns (BW <1000 g) with gestational age (GA) <33 weeks and echocardiographic diagnosis of PDA, from 16 neonatal units of the BNRN from January 1, 2010 to December 31, 2011. Newborns who died or were transferred until the third day of life, and those with presence of congenital mal-formation or infection were excluded. Groups: G1 - conservative approach (without treatment), G2 - pharmacologic (indomethacin or ibuprofen), G3 - surgical ligation (independent of previous treatment). Factors analyzed: antenatal corticosteroid, cesarean section, BW, GA, 5 min. Apgar score <4, male gender, Score for Neonatal Acute Physiology Perinatal Extension (SNAPPEII), respiratory distress syndrome (RDS), late sepsis (LS), mechanical ventilation (MV), surfactant (<2 h of life), and time of MV. Outcomes: death, O-2 dependence at 36 weeks (BPD36wks), IVH III/IV, ROPsur, NECsur, and death/BPD36wks. Statistics: Student's t-test, Chi-squared test, or Fisher's exact test; Odds ratio (95% CI); logistic binary regression and backward stepwise multiple regression. Software: MedCalc (Medical Calculator) software, version 12.1.4.0. p values <0.05 were considered statistically significant. Results: 1097 newborns were selected and 494 newborns were included: G1 - 187 (37.8%), G2 - 205 (41.5%), and G3 102 (20.6%). The highest mortality was observed in G1 (51.3%) and the lowest in G3 (14.7%). The highest frequencies of BPD36wks (70.6%) and ROPsur were observed in G3 (23.5%). The lowest occurrence of death/BPD36wks occurred in G2 (58.0%). Pharmacological (OR 0.29; 95% CI: 0.14 - 0.62) and conservative (OR 0.34; 95% CI: 0.140.79) treatments were protective for the outcome death/BPD36wks. Conclusion: The conservative approach of PDA was associated to high mortality, the surgical approach to the occurrence of BPD36wks and ROPsur, and the pharmacological treatment was protective for the outcome death/BPD36wks.

引用

页码：233 / 234

页数：2