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International Variation in the Management of Patent Ductus Arteriosus and Its Association with Infant Outcomes : A Survey and Linked Cohort Study
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- Isayama, Tetsuya (författare)
- Division of Neonatology, Center for Maternal-Fetal Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
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- Kusuda, Satoshi (författare)
- Neonatal Research Network Japan, Maternal and Perinatal Center, Tokyo Women's Medical University, Tokyo, Japan
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- Adams, Mark (författare)
- Swiss Neonatal Network, Department of Neonatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
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- Berti, Elettra (författare)
- Neonatal Intensive Care Unit, Medical Surgical Fetal-Neonatal Department, Anna Meyer Children's University Hospital, Florence, Italy
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- Battin, Malcolm (författare)
- Department of Neonatology, Auckland District Health Board, Auckland, New Zealand
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- Helenius, Kjell (författare)
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital, Turku, Finland; Department of Clinical Medicine, University of Turku, Turku, Finland
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- Håkansson, Stellan (författare)
- Umeå universitet,Pediatrik
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- Vento, Maximo (författare)
- Division of Neonatology, Health Research Institute La Fe, Valencia, Spain
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- Norman, Mikael (författare)
- Karolinska Institutet
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- Reichman, Brian (författare)
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel
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- Noguchi, Akihiko (författare)
- Illinois Neonatal Network, Saint Louis University, IL, Saint Louis, United States
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- Lee, Shoo K. (författare)
- Department of Pediatrics, Mount Sinai Hospital, Ontario, Toronto, Canada; Department of Pediatrics, University of Toronto, Ontario, Toronto, Canada
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- Bassler, Dirk (författare)
- Swiss Neonatal Network, Department of Neonatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
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- Lui, Kei (författare)
- Department of Newborn Care, Royal Hospital for Women and School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, NSW, Sydney, Australia
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- Lehtonen, Liisa (författare)
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital, Turku, Finland; Department of Clinical Medicine, University of Turku, Turku, Finland
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- Yang, Junmin (författare)
- Department of Pediatrics, Mount Sinai Hospital, Ontario, Toronto, Canada
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- Shah, Prakesh S. (författare)
- Department of Pediatrics, Mount Sinai Hospital, Ontario, Toronto, Canada; Department of Pediatrics, University of Toronto, Ontario, Toronto, Canada
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(creator_code:org_t)
- Elsevier, 2022
- 2022
- Engelska.
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Ingår i: The Journal of Pediatrics. - : Elsevier. - 0022-3476 .- 1097-6833. ; 244, s. 24-29
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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http://kipublication...
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Abstract
Ämnesord
Stäng
- Objective: To assess whether treating patients with a presymptomatic patent ductus arteriosus (PDA), based on early routine echocardiography, performed regardless of clinical signs, improved outcomes. Study design: This multicenter, survey-linked retrospective cohort study used an institutional-level questionnaire and individual patient-level data and included infants of <29 weeks of gestation born in 2014-2016 and admitted to tertiary neonatal intensive care units (NICUs) of 9 population-based national or regional neonatal networks. Infants in NICUs receiving treatment of presymptomatic PDA identified by routine echocardiography and those not were compared for the primary composite outcome (early death [≤7 days after birth] or severe intraventricular hemorrhage) and secondary outcomes (any in-hospital mortality and major morbidities). Results: The unit survey (response rates of 86%) revealed a wide variation among networks in the treatment of presymptomatic PDA (7%-86%). Among 246 NICUs with 17 936 infants (mean gestational age of 26 weeks), 126 NICUs (51%) with 7785 infants treated presymptomatic PDA. The primary outcome of early death or severe intraventricular hemorrhage was not significantly different between the NICUs treating presymptomatic PDA and those who did not (17% vs 21%; aOR 1.00, 95% CI 0.85-1.18). The NICUs treating presymptomatic PDA had greater odds of retinopathy of prematurity treatment (13% vs 7%; aOR 1.47, 95% CI 1.01-2.12); however, it was not significant in a sensitivity analysis excluding Japanese data. Conclusions: Treating presymptomatic PDA detected by routine echocardiography was commonplace but associated with no significant benefits. Well-designed trials are needed to assess the efficacy and safety of early targeted PDA treatment.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Pediatrik (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Pediatrics (hsv//eng)
Nyckelord
- echocardiography
- infants born preterm
- patent ductus arteriosus
- questionnaire survey
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Isayama, Tetsuya
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Kusuda, Satoshi
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Adams, Mark
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Berti, Elettra
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Battin, Malcolm
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Helenius, Kjell
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visa fler...
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Håkansson, Stell ...
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Vento, Maximo
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Norman, Mikael
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Reichman, Brian
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Noguchi, Akihiko
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Lee, Shoo K.
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Bassler, Dirk
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Lui, Kei
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Lehtonen, Liisa
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Yang, Junmin
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Shah, Prakesh S.
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Pediatrik
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The Journal of P ...
- Av lärosätet
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Umeå universitet
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Karolinska Institutet