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Pharmacological Ductus Arteriosus Treatment in Infants Born at 22-23 Gestational Weeks
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.ORCID iD: 0000-0001-8382-8687
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
2011 (English)In: Pediatric Research, Nature Publishing Group, 2011, Vol. 70, 268-268 p., S5Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

Background: Improvements in neonatal care have increased survival rates for extremely premature infants. Patency of the ductus arteriosus is common among these infants and incidence relates inversely to gestational age. First-line treatment is COX-inhibitors, which is known to affect renal, pulmonary and cerebral blood flow and to increase risks of several morbidities. The efficacy of this treatment has not been confirmed in the very most preterm infants.Aim: To investigate the efficacy of pharmacological ductus arteriosus treatment in infants born at 22-23 weeks of gestation.Method: infants born at 22-23 weeks of gestation at Akademiska children's hospital between January 2006 and December 2010 were retrospectively identified and treatment and outcome parameters evaluated. Routine care for these infants included echocardiography during the first days of life and pharmacological treatment with indomethacin if echocardiographic or clinical signs of a hemodynamically significant ductus were present.Results: Fifty-three infants were born at 22-23 weeks gestation and 22 received pharmacological treatment for ductus arteriosus. Seven infants received ibuprofen due to shortage of indomethacin. Four (18%) infants obtained lasting ductal closure after pharmacological treatment. Four infants spontaneously closed their ductus later, three died, one received a second ibuprofen course, eight carried on to secondary surgical closure and two were discharged with a still patent ductus.Conclusion: Standard pharmacological treatment does not seem to effectively close ductus arteriosus in infants born at 22-23 gestational weeks.

Place, publisher, year, edition, pages
Nature Publishing Group, 2011. Vol. 70, 268-268 p., S5
Series
Pediatric Research, ISSN 0031-3998
Keyword [en]
patent ductus arteriosus, extremely preterm, cyclooxygenase inhibitors
National Category
Pediatrics
Research subject
Pediatrics
Identifiers
URN: urn:nbn:se:uu:diva-216813DOI: 10.1038OAI: oai:DiVA.org:uu-216813DiVA: diva2:690956
Conference
Annual Meeting of the European Society for Paediatric Research (ESPR), 14-17 oktober, Newcastle, Storbritannien
Funder
Knut and Alice Wallenberg Foundation
Available from: 2014-01-25 Created: 2014-01-25 Last updated: 2017-03-23

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Publisher's full texthttp://dx.doi.org/10.1038/pr.2011.493

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Olsson, Karl Wilhelm

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