Souvik Mitra1, Anthony K Chan2, Bosco A Paes1. 1. a Division of Neonatology , McMaster Children's Hospital, McMaster University , Hamilton , Ontario , Canada , and. 2. b Division of Pediatric Hematology/Oncology , McMaster Children's Hospital, McMaster University , Hamilton , Ontario , Canada.
Abstract
OBJECTIVE: To conduct a meta-analysis of the association of platelet counts and pharmacotherapeutic failure in preterms with a patent ductus arteriosus (PDA). METHODS: MEDLINE, Embase, Science Citation Index, abstracts and conference proceedings were searched, and principal authors contacted. Included studies reported indomethacin or ibuprofen use for PDA closure, compared a group which failed treatment versus a group which did not and reported the association between platelet counts and indomethacin or ibuprofen failure. Two reviewers independently screened results and assessed methodological quality using the Newcastle-Ottawa Scale. Results are expressed as mean difference in platelet counts and summary odds ratios (OR) using a random effects model. RESULTS: 1105 relevant studies were identified; eight involving 1087 preterms were included. Platelet counts were significantly lower in infants who failed pharmacotherapy (Meandifference:-30.88 × 109/L; 95% CI:-45.69 × 109,-16.07 × 109/L; I2 = 24%; pheterogeneity = 0.24). Similar results were obtained based on either pharmacotherapeutic agent. Treatment failure was also significantly associated with pre-treatment thrombocytopenia (summary OR:1.75; 95% CI:1.23-2.49, I2 = 36%, pheterogeneity = 0.20). CONCLUSIONS: Platelet counts are significantly lower in preterms who fail primary treatment for PDA. Pre-treatment thrombocytopenia is associated with higher odds of failure. Further cohort studies reporting platelet counts in prostaglandin inhibitor failure are needed for meta-analyses to firmly establish or refute a stronger association.
OBJECTIVE: To conduct a meta-analysis of the association of platelet counts and pharmacotherapeutic failure in preterms with a patent ductus arteriosus (PDA). METHODS: MEDLINE, Embase, Science Citation Index, abstracts and conference proceedings were searched, and principal authors contacted. Included studies reported indomethacin or ibuprofen use for PDA closure, compared a group which failed treatment versus a group which did not and reported the association between platelet counts and indomethacin or ibuprofen failure. Two reviewers independently screened results and assessed methodological quality using the Newcastle-Ottawa Scale. Results are expressed as mean difference in platelet counts and summary odds ratios (OR) using a random effects model. RESULTS: 1105 relevant studies were identified; eight involving 1087 preterms were included. Platelet counts were significantly lower in infants who failed pharmacotherapy (Meandifference:-30.88 × 109/L; 95% CI:-45.69 × 109,-16.07 × 109/L; I2 = 24%; pheterogeneity = 0.24). Similar results were obtained based on either pharmacotherapeutic agent. Treatment failure was also significantly associated with pre-treatment thrombocytopenia (summary OR:1.75; 95% CI:1.23-2.49, I2 = 36%, pheterogeneity = 0.20). CONCLUSIONS: Platelet counts are significantly lower in preterms who fail primary treatment for PDA. Pre-treatment thrombocytopenia is associated with higher odds of failure. Further cohort studies reporting platelet counts in prostaglandin inhibitor failure are needed for meta-analyses to firmly establish or refute a stronger association.
Authors: Hannes Sallmon; Sven C Weber; Juliane Dirks; Tamara Schiffer; Tamara Klippstein; Anja Stein; Ursula Felderhoff-Müser; Boris Metze; Georg Hansmann; Christoph Bührer; Malte Cremer; Petra Koehne Journal: Front Pediatr Date: 2018-03-07 Impact factor: 3.418
Authors: Hannes Sallmon; Natalie Timme; Begüm Atasay; Ömer Erdeve; Georg Hansmann; Yogen Singh; Sven C Weber; Elaine L Shelton Journal: Front Pediatr Date: 2021-02-25 Impact factor: 3.418
Authors: Ömer Erdeve; Emel Okulu; Yogen Singh; Richard Sindelar; Mehmet Yekta Oncel; Gianluca Terrin; Giovanni Boscarino; Ali Bülbül; Hannes Sallmon; Begüm Atasay; Fahri Ovalı; Ronald I Clyman Journal: Turk Arch Pediatr Date: 2022-03