An observational, prospective, multicenter, registry-based cohort study comparing conservative and medical management for patent ductus arteriosus

dc.contributor.buuauthorÖzkan, Hilal
dc.contributor.departmentBursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları.tr_TR
dc.contributor.researcheridIGT-7005-2023
dc.contributor.scopusid16679325400tr_TR
dc.date.accessioned2024-02-05T12:06:41Z
dc.date.available2024-02-05T12:06:41Z
dc.date.issued2020-07-31
dc.descriptionÇalışmada 25 yazar bulunmaktadır. Bu yazarlardan sadece Bursa Uludağ Üniversitesi mensuplarının girişleri yapılmıştır.tr_TR
dc.description.abstractNo consensus has been reached on which patent ductus arteriosus (PDAs) in preterm infants require treatment and if so, how, and when they should be treated. A prospective, multicenter, cohort study was conducted to compare the effects of conservative approaches and medical treatment options on ductal closure at discharge, surgical ligation, prematurity-related morbidities, and mortality. Infants between 240/7 and 286/7 weeks of gestation from 24 neonatal intensive care units were enrolled. Data on PDA management and patients' clinical characteristics were recorded prospectively. Patients with moderate-to-large PDA were compared. Among the 1,193 enrolled infants (26.7 ± 1.4 weeks and 926 ± 243 g), 649 (54%) had no or small PDA, whereas 544 (46%) had moderate-to-large PDA. One hundred thirty (24%) infants with moderate-to-large PDA were managed conservatively, in contrast to 414 (76%) who received medical treatment. Eighty (62%) of 130 infants who were managed conservatively did not receive any rescue treatment and the PDA closure rate was 53% at discharge. There were no differences in the rates of late-onset sepsis, necrotizing enterocolitis (NEC), retinopathy of prematurity, intraventricular hemorrhage (≥Grade 3), surgical ligation, and presence of PDA at discharge between conservatively-managed and medically-treated infants (p > 0.05). Multivariate analysis including perinatal factors showed that medical treatment was associated with increased risk for mortality (OR 1.68, 95% Cl 1.01–2.80, p = 0.046), but decreased risk for BPD or death (BPD/death) (OR 0.59, 95%Cl 0.37–0.92, p = 0.022). The preferred treatment options were ibuprofen (intravenous 36%, oral 31%), and paracetamol (intravenous 26%, oral 7%). Infants who were treated with oral paracetamol had higher rates of NEC and mortality in comparison to other treatment options. Infants treated before postnatal day 7 had higher rates of mortality and BPD/death than infants who were conservatively managed or treated beyond day 7 (p = 0.009 and 0.007, respectively). In preterm infants born at <29 weeks of gestation with moderate-to-large PDA, medical treatment did not show any reduction in the rates of open PDA at discharge, surgical or prematurity-related secondary outcomes. In addition to the high incidence of spontaneous closure of PDA in the first week of life, early treatment (<7 days) was associated with higher rates of mortality and BPD/death. en_US
dc.description.sponsorshipAnkara University School of Medicine, Ankara, Turkey en_US
dc.description.sponsorshipAtaturk University School of Medicine, Erzurum, Turkey en_US
dc.description.sponsorshipDepartment of Biostatistics en_US
dc.description.sponsorshipIzmir Behcet Uz Children's Hospital en_US
dc.description.sponsorshipKaradeniz Teknik University School of Medicine en_US
dc.description.sponsorshipTurkish Neonatal Society (1-2017) en_US
dc.description.sponsorshipUniversity of Health Sciences en_US
dc.description.sponsorshipYuzuncu Yil University School of Medicine en_US
dc.description.sponsorshipHacettepe Üniversitesi en_US
dc.description.sponsorshipDokuz Eylül Üniversitesi en_US
dc.identifier.citationOkulu, E. vd. (2020). "An observational, prospective, multicenter, registry-based cohort study comparing conservative and medical management for patent ductus arteriosus". Frontiers in Pediatrics, 8. en_US
dc.identifier.doihttps://doi.org/10.3389/fped.2020.00434
dc.identifier.issn2296-2360
dc.identifier.pubmed32850547tr_TR
dc.identifier.scopus2-s2.0-85089525278tr_TR
dc.identifier.urihttps://www.frontiersin.org/articles/10.3389/fped.2020.00434/full
dc.identifier.urihttps://hdl.handle.net/11452/39522
dc.identifier.volume8tr_TR
dc.identifier.wos000561673100001tr_TR
dc.indexed.scopusScopus en_US
dc.indexed.wosSCIE en_US
dc.language.isoen en_US
dc.publisherFrontiers Media SA en_US
dc.relation.collaborationYurt içitr_TR
dc.relation.collaborationSanayitr_TR
dc.relation.journalFrontiers in Pediatrics en_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergitr_TR
dc.rightsinfo:eu-repo/semantics/closedAccess en_US
dc.subjectPatent ductus arteriosus en_US
dc.subjectPreterm en_US
dc.subjectConservative en_US
dc.subjectManagement en_US
dc.subjectMorbidity en_US
dc.subjectMortality en_US
dc.subjectIbuprofen en_US
dc.subjectParacetamol en_US
dc.subjectPreterm infants en_US
dc.subjectProphylactic indomethacin en_US
dc.subjectOutcomes en_US
dc.subjectAssociation en_US
dc.subjectDiagnosis en_US
dc.subjectIbuprofen en_US
dc.subjectClosure en_US
dc.subjectSafety en_US
dc.subjectPediatrics en_US
dc.subject.emtreeArtificial lung surfactant en_US
dc.subject.emtreeIbuprofen en_US
dc.subject.emtreeParacetamol en_US
dc.subject.emtreeSteroid en_US
dc.subject.emtreeArtery ligation en_US
dc.subject.emtreeArticle en_US
dc.subject.emtreeAssisted ventilation en_US
dc.subject.emtreeBrain hemorrhage en_US
dc.subject.emtreeClinical feature en_US
dc.subject.emtreeCohort analysis en_US
dc.subject.emtreeConfidence interval en_US
dc.subject.emtreeConservative treatment en_US
dc.subject.emtreeControlled study en_US
dc.subject.emtreeFemale en_US
dc.subject.emtreeGestational age en_US
dc.subject.emtreeHospital discharge en_US
dc.subject.emtreeHuman en_US
dc.subject.emtreeInfant en_US
dc.subject.emtreeInfant mortality en_US
dc.subject.emtreeLung dysplasia en_US
dc.subject.emtreeMajor clinical study en_US
dc.subject.emtreeMale en_US
dc.subject.emtreeMulticenter study en_US
dc.subject.emtreeMultivariate analysis en_US
dc.subject.emtreeNecrotizing enterocolitis en_US
dc.subject.emtreeNeonatal intensive care unit en_US
dc.subject.emtreeNeonatal respiratory distress syndrome en_US
dc.subject.emtreeNewborn morbidity en_US
dc.subject.emtreeNewborn sepsis en_US
dc.subject.emtreeObservational study en_US
dc.subject.emtreeOdds ratio en_US
dc.subject.emtreeOutcome assessment en_US
dc.subject.emtreePatent ductus arteriosus en_US
dc.subject.emtreePerinatal period en_US
dc.subject.emtreePregnancy en_US
dc.subject.emtreePrematurity en_US
dc.subject.emtreeProspective study en_US
dc.subject.emtreeRetrolental fibroplasia en_US
dc.subject.emtreeRisk factor en_US
dc.subject.emtreeRisk reduction en_US
dc.subject.emtreeSurgical technique en_US
dc.subject.emtreeSurvival rate en_US
dc.subject.scopusPatent Ductus Arteriosus; Prematurity; Newbornen_US
dc.subject.wosPediatricsen_US
dc.titleAn observational, prospective, multicenter, registry-based cohort study comparing conservative and medical management for patent ductus arteriosusen_US
dc.typeArticleen_US
dc.wos.quartileQ1en_US

Files

License bundle

Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
1.71 KB
Format:
Item-specific license agreed upon to submission
Description: