Neidín Bussmann1, Aisling Smith1, Colm R Breatnach1, Naomi McCallion1,2, Brian Cleary3,4, Orla Franklin5, Patrick J McNamara6,7,8, Afif El-Khuffash9,10. 1. Department of Neonatology, The Rotunda Hospital, Dublin, Ireland. 2. Department of Paediatrics, The Royal College of Surgeons in Ireland, Dublin, Ireland. 3. Department of Pharmacy, The Rotunda Hospital, Dublin, Ireland. 4. School of Pharmacy, Royal College of Surgeons in Ireland, Dublin, Ireland. 5. Department of Paediatric Cardiology, Our Lady's Children's Hospital Crumlin, Dublin, Ireland. 6. Division of Neonatology, Stead Family Children's Hospital, Iowa City, IA, USA. 7. Departments of Pediatrics and Cardiology, University of Iowa, Iowa City, IA, USA. 8. Cardiology, University of Iowa, Iowa City, IA, USA. 9. Department of Neonatology, The Rotunda Hospital, Dublin, Ireland. afifelkhuffash@rcsi.com. 10. Department of Paediatrics, The Royal College of Surgeons in Ireland, Dublin, Ireland. afifelkhuffash@rcsi.com.
Abstract
OBJECTIVE: A post hoc appraisal of the PDA RCT to assess the relationship between early patent ductus arteriosus (PDA) shunt elimination and chronic lung disease or death (CLD/Death). STUDY DESIGN: Infants <29 weeks were divided into four groups: intervention arm in whom PDA closure was achieved (n = 17); intervention arm in whom PDA closure was not achieved (n = 13); placebo arm (n = 30); low risk infants (n = 13). The main outcome measure was CLD/Death. RESULTS: The rates of CLD/Death were lower in the Intervention Success Group (29%) when compared to the Intervention Failure Group (85%) or the Placebo Group (60%, all p < 0.05). There was no difference in CLD/Death between the Intervention Success and Low Risk Groups (8%, p > 0.05). A persistent PDA beyond Day 8 was associated with CLD/Death (aOR 6.5 [1.7-25.5]). CONCLUSIONS: Early shunt elimination in preterm infants with a PDA may reduce respiratory morbidity when compared to infants with prolonged shunt exposure.
OBJECTIVE: A post hoc appraisal of the PDA RCT to assess the relationship between early patent ductus arteriosus (PDA) shunt elimination and chronic lung disease or death (CLD/Death). STUDY DESIGN: Infants <29 weeks were divided into four groups: intervention arm in whom PDA closure was achieved (n = 17); intervention arm in whom PDA closure was not achieved (n = 13); placebo arm (n = 30); low risk infants (n = 13). The main outcome measure was CLD/Death. RESULTS: The rates of CLD/Death were lower in the Intervention Success Group (29%) when compared to the Intervention Failure Group (85%) or the Placebo Group (60%, all p < 0.05). There was no difference in CLD/Death between the Intervention Success and Low Risk Groups (8%, p > 0.05). A persistent PDA beyond Day 8 was associated with CLD/Death (aOR 6.5 [1.7-25.5]). CONCLUSIONS: Early shunt elimination in preterm infants with a PDA may reduce respiratory morbidity when compared to infants with prolonged shunt exposure.