An observational, prospective, multicenter, registry-based cohort study comparing conservative and medical management for patent ductus arteriosus
dc.contributor.buuauthor | Özkan, Hilal | |
dc.contributor.department | Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları. | tr_TR |
dc.contributor.researcherid | IGT-7005-2023 | |
dc.contributor.scopusid | 16679325400 | tr_TR |
dc.date.accessioned | 2024-02-05T12:06:41Z | |
dc.date.available | 2024-02-05T12:06:41Z | |
dc.date.issued | 2020-07-31 | |
dc.description | Çalışmada 25 yazar bulunmaktadır. Bu yazarlardan sadece Bursa Uludağ Üniversitesi mensuplarının girişleri yapılmıştır. | tr_TR |
dc.description.abstract | No 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.sponsorship | Ankara University School of Medicine, Ankara, Turkey | en_US |
dc.description.sponsorship | Ataturk University School of Medicine, Erzurum, Turkey | en_US |
dc.description.sponsorship | Department of Biostatistics | en_US |
dc.description.sponsorship | Izmir Behcet Uz Children's Hospital | en_US |
dc.description.sponsorship | Karadeniz Teknik University School of Medicine | en_US |
dc.description.sponsorship | Turkish Neonatal Society (1-2017) | en_US |
dc.description.sponsorship | University of Health Sciences | en_US |
dc.description.sponsorship | Yuzuncu Yil University School of Medicine | en_US |
dc.description.sponsorship | Hacettepe Üniversitesi | en_US |
dc.description.sponsorship | Dokuz Eylül Üniversitesi | en_US |
dc.identifier.citation | Okulu, 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.doi | https://doi.org/10.3389/fped.2020.00434 | |
dc.identifier.issn | 2296-2360 | |
dc.identifier.pubmed | 32850547 | tr_TR |
dc.identifier.scopus | 2-s2.0-85089525278 | tr_TR |
dc.identifier.uri | https://www.frontiersin.org/articles/10.3389/fped.2020.00434/full | |
dc.identifier.uri | https://hdl.handle.net/11452/39522 | |
dc.identifier.volume | 8 | tr_TR |
dc.identifier.wos | 000561673100001 | tr_TR |
dc.indexed.scopus | Scopus | en_US |
dc.indexed.wos | SCIE | en_US |
dc.language.iso | en | en_US |
dc.publisher | Frontiers Media SA | en_US |
dc.relation.collaboration | Yurt içi | tr_TR |
dc.relation.collaboration | Sanayi | tr_TR |
dc.relation.journal | Frontiers in Pediatrics | en_US |
dc.relation.publicationcategory | Makale - Uluslararası Hakemli Dergi | tr_TR |
dc.rights | info:eu-repo/semantics/closedAccess | en_US |
dc.subject | Patent ductus arteriosus | en_US |
dc.subject | Preterm | en_US |
dc.subject | Conservative | en_US |
dc.subject | Management | en_US |
dc.subject | Morbidity | en_US |
dc.subject | Mortality | en_US |
dc.subject | Ibuprofen | en_US |
dc.subject | Paracetamol | en_US |
dc.subject | Preterm infants | en_US |
dc.subject | Prophylactic indomethacin | en_US |
dc.subject | Outcomes | en_US |
dc.subject | Association | en_US |
dc.subject | Diagnosis | en_US |
dc.subject | Ibuprofen | en_US |
dc.subject | Closure | en_US |
dc.subject | Safety | en_US |
dc.subject | Pediatrics | en_US |
dc.subject.emtree | Artificial lung surfactant | en_US |
dc.subject.emtree | Ibuprofen | en_US |
dc.subject.emtree | Paracetamol | en_US |
dc.subject.emtree | Steroid | en_US |
dc.subject.emtree | Artery ligation | en_US |
dc.subject.emtree | Article | en_US |
dc.subject.emtree | Assisted ventilation | en_US |
dc.subject.emtree | Brain hemorrhage | en_US |
dc.subject.emtree | Clinical feature | en_US |
dc.subject.emtree | Cohort analysis | en_US |
dc.subject.emtree | Confidence interval | en_US |
dc.subject.emtree | Conservative treatment | en_US |
dc.subject.emtree | Controlled study | en_US |
dc.subject.emtree | Female | en_US |
dc.subject.emtree | Gestational age | en_US |
dc.subject.emtree | Hospital discharge | en_US |
dc.subject.emtree | Human | en_US |
dc.subject.emtree | Infant | en_US |
dc.subject.emtree | Infant mortality | en_US |
dc.subject.emtree | Lung dysplasia | en_US |
dc.subject.emtree | Major clinical study | en_US |
dc.subject.emtree | Male | en_US |
dc.subject.emtree | Multicenter study | en_US |
dc.subject.emtree | Multivariate analysis | en_US |
dc.subject.emtree | Necrotizing enterocolitis | en_US |
dc.subject.emtree | Neonatal intensive care unit | en_US |
dc.subject.emtree | Neonatal respiratory distress syndrome | en_US |
dc.subject.emtree | Newborn morbidity | en_US |
dc.subject.emtree | Newborn sepsis | en_US |
dc.subject.emtree | Observational study | en_US |
dc.subject.emtree | Odds ratio | en_US |
dc.subject.emtree | Outcome assessment | en_US |
dc.subject.emtree | Patent ductus arteriosus | en_US |
dc.subject.emtree | Perinatal period | en_US |
dc.subject.emtree | Pregnancy | en_US |
dc.subject.emtree | Prematurity | en_US |
dc.subject.emtree | Prospective study | en_US |
dc.subject.emtree | Retrolental fibroplasia | en_US |
dc.subject.emtree | Risk factor | en_US |
dc.subject.emtree | Risk reduction | en_US |
dc.subject.emtree | Surgical technique | en_US |
dc.subject.emtree | Survival rate | en_US |
dc.subject.scopus | Patent Ductus Arteriosus; Prematurity; Newborn | en_US |
dc.subject.wos | Pediatrics | en_US |
dc.title | An observational, prospective, multicenter, registry-based cohort study comparing conservative and medical management for patent ductus arteriosus | en_US |
dc.type | Article | en_US |
dc.wos.quartile | Q1 | en_US |
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