Treatment of Patent Ductus Arteriosus with Cyclo-oxygenase Inhibitors beyond 2 Weeks of Age in Very Low Birth Weight Infants
Treatment of Patent Ductus Arteriosus with Cyclo-oxygenase Inhibitors beyond 2 Weeks of Age in Very Low Birth Weight Infants
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DOI：
10.1055/s-0035-1570340
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发表时间：
2016-05-01
影响因子：
2
通讯作者：
Hussain, Naveed
中科院分区：
文献类型：
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作者：
Lainwala, Shabnam;Hussain, Naveed
背景：在出生后早期，环氧合酶抑制剂（COX-I）治疗极低出生体重儿（VLBW）动脉导管未闭（PDA）已得到广泛认可，目的本研究的目的是确定产后考克斯-2的有效性。研究设计：对1990年至2008年期间入住两个三级NICU的VLBW婴儿进行回顾性队列研究。有症状的PDA的婴儿用COX-I治疗，药物治疗失败的婴儿适合手术结扎。通过手术结扎的需要来衡量COX-1治疗的有效性，（生存日[DOL] < 14，早期治疗组[ETG]）和晚期结果在1,289例PDA患儿中，1,082例（84%）接受COX-Ⅰ治疗; 1，046名（97%）婴儿处于ETG，36名（3%）婴儿处于LTG。COX-I处理后的PDA结扎率在ETG中为15%，在LTG中为14%（p值：不显著）。两组之间的人口统计学或发病率无显著差异。结论在极低出生体重儿中，晚期使用COX-1治疗PDA与早期治疗一样有效。对于有症状的PDA，在手术治疗前进行晚期COX-I治疗试验是必要的。
Background Cyclo-oxygenase inhibitors (COX-I) treatment of patent ductus arteriosus (PDA) in very low birth weight (VLBW) infants during the early postnatal period is well established, but their use beyond early postnatal period is not well studied.Objective The objective of this study was to determine the effectiveness of postnatal COX-I for PDA treatment beyond 2 weeks of age in VLBW infants.Study Design A retrospective cohort of VLBW infants admitted to two tertiary NICUs between 1990 and 2008 were studied. Infants with symptomatic PDA were treated with COX-I and infants with failed medical treatment were candidates for surgical ligation. Effectiveness of COX-I treatment, measured by the need for surgical ligation, was compared between early (day of life [DOL] < 14, early treatment group [ETG]) and late (DOL >= 14, late treatment group [LTG]) treatment groups.Results Of the 1,289 infants with PDA, 1,082 (84%) were treated with COX-I; 1,046 (97%) infants were in ETG and 36 (3%) in LTG. PDA ligation rates after COX-I treatment were 15% in ETG and 14% in LTG (p-value: not significant). There were no significant differences in demographics or morbidities between the two groups.Conclusions In VLBW infants, late treatment of PDAwith COX-I was as effective as early treatment. Trial of late COX-I treatment is warranted for symptomatic PDA before surgical treatment.