Clinical Outcome After A More Conservative Management Of Patent Ductus Arteriosus In Preterm Infants PDF Download
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Languages : en
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Introduction and aims: Management of patent ductus arteriosus (PDA) is still controversial in extremely low birthweight infants. We aim to describe the impact of a more conservative approach in medical and surgical treatment rates and in the outcome before discharge specially in preterm less than 26 weeks of gestation.Methods. Review of clinical charts of preterm infants u226430 weeks with a PDA diagnosis admitted in two NICUs between 2009 and 2016. In 2011 we changed our PDA management: before 2011, in the first period (P1), patients who failed medical treatment underwent surgical closure; after 2011, period 2 (P2), only those with cardiopulmonary compromise (mainly those that could not be weaned from ventilator) received surgery.Results: We included 188 patients (average 27u00b12 weeks and 973u00b1272 grams birth weight); 63 patients in P1 and 125 in P2. Both groups showed similar clinical characteristics. Significant lower rates of medical therapy (85.7% vs 56.0%) and surgical ligation (34.5% vs 16.1%) were observed in P2. There were no significant differences in the short-term outcomes between periods. After stratified analysis, an increased survival rate was observed in infants born below 26 weeks of gestation in the second period compare with those born below 26 weeks of gestation in the first group (45.6% vs 20%; p=0.028). Conclusions: A conservative approach in preterm infants with PDA can avoid medical and surgical treatments and its side effects, without a significant impact in survival-without-morbidity. However, two thirds of preterm infants born under 26 weeks are still treated for PDA.
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Languages : en
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Book Description
Introduction and aims: Management of patent ductus arteriosus (PDA) is still controversial in extremely low birthweight infants. We aim to describe the impact of a more conservative approach in medical and surgical treatment rates and in the outcome before discharge specially in preterm less than 26 weeks of gestation.Methods. Review of clinical charts of preterm infants u226430 weeks with a PDA diagnosis admitted in two NICUs between 2009 and 2016. In 2011 we changed our PDA management: before 2011, in the first period (P1), patients who failed medical treatment underwent surgical closure; after 2011, period 2 (P2), only those with cardiopulmonary compromise (mainly those that could not be weaned from ventilator) received surgery.Results: We included 188 patients (average 27u00b12 weeks and 973u00b1272 grams birth weight); 63 patients in P1 and 125 in P2. Both groups showed similar clinical characteristics. Significant lower rates of medical therapy (85.7% vs 56.0%) and surgical ligation (34.5% vs 16.1%) were observed in P2. There were no significant differences in the short-term outcomes between periods. After stratified analysis, an increased survival rate was observed in infants born below 26 weeks of gestation in the second period compare with those born below 26 weeks of gestation in the first group (45.6% vs 20%; p=0.028). Conclusions: A conservative approach in preterm infants with PDA can avoid medical and surgical treatments and its side effects, without a significant impact in survival-without-morbidity. However, two thirds of preterm infants born under 26 weeks are still treated for PDA.
Author: Begum Atasay
Publisher: Frontiers Media SA
ISBN: 2889668037
Category : Medical
Languages : en
Pages : 254
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Book Description
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 030910159X
Category : Medical
Languages : en
Pages : 791
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Book Description
The increasing prevalence of preterm birth in the United States is a complex public health problem that requires multifaceted solutions. Preterm birth is a cluster of problems with a set of overlapping factors of influence. Its causes may include individual-level behavioral and psychosocial factors, sociodemographic and neighborhood characteristics, environmental exposure, medical conditions, infertility treatments, and biological factors. Many of these factors co-occur, particularly in those who are socioeconomically disadvantaged or who are members of racial and ethnic minority groups. While advances in perinatal and neonatal care have improved survival for preterm infants, those infants who do survive have a greater risk than infants born at term for developmental disabilities, health problems, and poor growth. The birth of a preterm infant can also bring considerable emotional and economic costs to families and have implications for public-sector services, such as health insurance, educational, and other social support systems. Preterm Birth assesses the problem with respect to both its causes and outcomes. This book addresses the need for research involving clinical, basic, behavioral, and social science disciplines. By defining and addressing the health and economic consequences of premature birth, this book will be of particular interest to health care professionals, public health officials, policy makers, professional associations and clinical, basic, behavioral, and social science researchers.
Author: Henry C. Lee
Publisher:
ISBN: 9781610023986
Category : Medical
Languages : en
Pages : 0
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Book Description
Enhance your knowledge of neonatal-perinatal medicine and/or study for Neonatal-Perinatal Medicine board certification or recertification with this new study guide from the editors of NeoReviews. This new guide includes more than 1,200 questions previously published in NeoReviews from January 2007 to December 2017. Each question is followed by a short explanation of the correct answer with references, including the original article. Chapters include Cardiology Dermatology Endocrinology ENT and Ophthalmology Fluids, Electrolytes, Nutrition Gastrointestinal Genetics and Inborn Errors of Metabolism Hematology/Oncology Immunology Infectious Diseases Maternal-Fetal Medicine Neonatal Resuscitation Neurology Renal Respiratory Statistics, Research, Health Services, and Ethics
Author: Gabriel Altit
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Category :
Languages : en
Pages :
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Book Description
"Background: Extremely preterm infants (born at 29 weeks of estimated gestational age [EGA] or less), are at increased risk of mortality and morbidities. Although some evidence suggests that persistence of patent ductus arteriosus (PDA), common in premature newborns, contributes to adverse outcomes. Limited data on the benefits of PDA closure has led the American Academy of Pediatrics to recommend against nonsteroidal anti-inflammatory drugs (NSAIDs) use in preterm newborns for the purpose of PDA closure. Few studies to date have evaluated the outcome of this conservative approach. We hypothesize that a conservative approach policy is not associated with worsening of the outcome of death or bronchopulmonary dysplasia (BPD - defined as use of oxygen or respiratory support at 36 weeks corrected age) in babies born at 29 weeks and less, and most specifically in the most vulnerable ones born at
Author: Eduardo Bancalari
Publisher: Elsevier Health Sciences
ISBN: 0323568750
Category : Medical
Languages : en
Pages : 464
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Book Description
Dr. Richard Polin’s Neonatology Questions and Controversies series highlights the most challenging aspects of neonatal care, offering trustworthy guidance on up-to-date diagnostic and treatment options in the field. In each volume, renowned experts address the clinical problems of greatest concern to today’s practitioners, helping you handle difficult practice issues and provide optimal, evidence-based care to every patient. Stay fully up to date in this fast-changing field with The Newborn Lung, 3rd Edition. The most current clinical information throughout, including key management strategies that may reduce some of the chronic sequelae of neonatal respiratory failure. New content on the role of microbiome in lung injury and lung development. Current coverage of non-invasive respiratory support, perinatal events and their influence on lung development and injury, cell-based lung therapy, automation of respiratory support, and oxygenation targeting in preterm infants. Consistent chapter organization to help you find information quickly and easily. The most authoritative advice available from world-class neonatologists who share their knowledge of new trends and developments in neonatal care. Purchase each volume individually, or get the entire 7-volume set! Gastroenterology and Nutrition Hematology, Immunology and Genetics Hemodynamics and Cardiology Infectious Disease and Pharmacology New Volume! Nephrology and Fluid/Electrolyte Physiology Neurology The Newborn Lung
Author: Mary Ellen McCann
Publisher: Cambridge University Press
ISBN: 1107069777
Category : Medical
Languages : en
Pages : 465
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Book Description
A practical, comprehensive guide to the special needs of infants and neonates undergoing anesthesia.
Author: B. Koletzko
Publisher: Karger Medical and Scientific Publishers
ISBN: 3318026417
Category : Medical
Languages : en
Pages : 328
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Book Description
Improved conditions of care for premature infants have led to markedly increased survival rates over the last few decades, particularly in very low and extremely low birth weight infants. Nutritional measures play a central role in the long-term outcome, health and quality of life of these premature infants. In this publication, leading experts from all 5 continents present the most recent evidence and critical analyses of nutrient requirements and the practice of nutritional care (with the focus on very low birth weight infants) to provide guidance for clinical application. After the introductory chapters, covering nutritional needs and research evidence in a more general manner, topics such as amino acids and proteins, lipids, microminerals and vitamins, parenteral and enteral nutrition as well as approaches to various disease conditions are addressed. Due to its focus on critical appraisals and recommendations, this book is of interest not only for the researcher who wants to keep up to date, but also for the clinician faced with premature infants in his practice.
Author: Eduardo da Cruz
Publisher: Springer
ISBN: 9781447146186
Category : Medical
Languages : en
Pages : 3572
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Book Description
Pediatric and Congenital Cardiology, Cardiac Surgery and Intensive Care provides a consistent and comprehensive approach to multiple congenital and acquired cardiac pathologies pre, peri and postoperatively, with the use of algorhythms, guidelines and current research issues. Included with the e-reference are interactive videos with the most common interventions, online access to practical learning activities, and to the comprehensive Aristotle score and database. This reference work satisfies the need for a universal and practical review of management of critically ill children and adults with congenital heart disease, based upon taskforce decisions and the cumulative experience of the world leaders in the field.
Author: Charles Vacanti
Publisher: Cambridge University Press
ISBN: 1139498401
Category : Medical
Languages : en
Pages : 1191
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Book Description
The clinical practice of anesthesia has undergone many advances in the past few years, making this the perfect time for a new state-of-the-art anesthesia textbook for practitioners and trainees. The goal of this book is to provide a modern, clinically focused textbook giving rapid access to comprehensive, succinct knowledge from experts in the field. All clinical topics of relevance to anesthesiology are organized into 29 sections consisting of more than 180 chapters. The print version contains 166 chapters that cover all of the essential clinical topics, while an additional 17 chapters on subjects of interest to the more advanced practitioner can be freely accessed at www.cambridge.org/vacanti. Newer techniques such as ultrasound nerve blocks, robotic surgery and transesophageal echocardiography are included, and numerous illustrations and tables assist the reader in rapidly assimilating key information. This authoritative text is edited by distinguished Harvard Medical School faculty, with contributors from many of the leading academic anesthesiology departments in the United States and an introduction from Dr S. R. Mallampati. This book is your essential companion when preparing for board review and recertification exams and in your daily clinical practice.
