Late oral acetaminophen versus immediate surgical ligation in preterm infants with persistent large patent ductus arteriosus

The Journal of Thoracic and Cardiovascular Surgery
Sally MashallyDany E Weisz

Abstract

The study objective was to evaluate the association of oral acetaminophen therapy versus immediate surgical ligation with neonatal outcomes in infants with persistent patent ductus arteriosus. We performed a retrospective cohort study of preterm infants born 28+6 weeks or less gestational age with persistent large patent ductus arteriosus being considered for surgical ligation after unsuccessful medical therapy. Infants in epoch 1 (July 2009 to June 2012) were immediately referred for ligation, and infants in epoch 2 (July 2012 to June 2015) were treated with oral acetaminophen and referred for ligation in the absence of improvement. The primary outcome was a composite of death or chronic lung disease. A total of 92 infants with median (interquartile range) gestational age 25.2 weeks (24.4-26.3) had persistent large patent ductus arteriosus (43 in epoch 1, 49 in epoch 2). Infants in epoch 2 had decreased surgical ligation (26 [53%] vs 31 [72%]; adjusted odds ratio [aOR], 0.32; 95% confidence interval [CI], 0.12-0.89) but increased chronic lung disease (36 [73%] vs 25 [58%]; aOR, 3.34; 95% CI, 1.05-10.58) and increased death/chronic lung disease of borderline significance (39 [80%] vs 29 [67%]; aOR, 3.09; 95% CI, 0.99-9.63). Inf...Continue Reading

Citations

Aug 26, 2020·The Journal of Pediatric Pharmacology and Therapeutics : JPPT : the Official Journal of PPAG·Ronnelle KingKate A Tauber
Dec 31, 2019·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Arvind SehgalKenneth Tan
Mar 29, 2020·Pediatric Research·David Staunton, Afif El-Khuffash
Oct 29, 2020·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Yu Mi SeoSook Kyung Yum
Feb 23, 2021·The Journal of Pediatrics·Clyde J Wright
Aug 29, 2021·Journal of Perinatology : Official Journal of the California Perinatal Association·Sally MashallyDany E Weisz
Oct 24, 2020·Pediatrics·Shannon E G HamrickGeorg Hansmann

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