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Determinants of surgical repair of patent ductus arteriosus in low-birth-weight infants

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Abstract

Purpose

To identify risk factors related to the failure of indomethacin therapy and the need for surgical repair in patent ductus arteriosus (PDA) in extremely low-birth-weight (<1000 g) infants (ELBWI).

Methods

Study subjects were 36 ELBWI with PDA born at a single tertiary perinatal center. They were classified into those who required surgery due to failure of indomethacin treatment (surgical group, n = 21) and those with effective indomethacin treatment (non-surgical group, n = 15). The odds ratios (ORs) and 95% confidence intervals (95% CIs) for the relationship between selected risk factors and surgical treatment of PDA were calculated.

Results

Gestational age of <28 weeks and diameter of PDA of 2 mm or more were independent and significant determinants of the need for surgical repair of PDA (adjusted ORs [95% CIs] = 9.91 [1.16–84.48] and 24.80 [2.72–225.74], respectively). The need for surgical repair of PDA did not correlate with sex, birth weight, 1-min Apgar score, left atrium diameter/aortic diameter (LA/Ao), left ventricular internal dimension at end-diastole, prophylaxes with indomethacin, and total dosage of indomethacin.

Conclusions

Gestational age at birth of <28 weeks and diameter of PDA of 2 mm or more are determinants of failure of indomethacin treatment for PDA and the need for surgical repair.

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Authors and Affiliations

  1. Department of Pediatrics, Faculty of Medicine, Fukuoka University, 45-1-7 Nanakuma, Jonan, Fukuoka, 814-0180, Japan

    Yukako Yoshikane & Shinichi Hirose

  2. Center for Maternal, Fetal and Neonatal Medicine, Fukuoka University Hospital, Fukuoka, Japan

    Toshiko Mori & Toshiyuki Yoshizato

  3. Department of Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan

    Yoshihiro Miyake

Authors
  1. Yukako Yoshikane
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  2. Toshiko Mori
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  3. Toshiyuki Yoshizato
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  4. Yoshihiro Miyake
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  5. Shinichi Hirose
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Corresponding author

Correspondence to Yukako Yoshikane.

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Yoshikane, Y., Mori, T., Yoshizato, T. et al. Determinants of surgical repair of patent ductus arteriosus in low-birth-weight infants. J Med Ultrasonics 38, 151–155 (2011). https://doi.org/10.1007/s10396-011-0309-8

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  • DOI: https://doi.org/10.1007/s10396-011-0309-8

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