Transcatheter Closure of Patent Ductus Arteriosus in Infants With Weight Under 1,500 Grams.
Transcatheter Closure of Patent Ductus Arteriosus in Infants With Weight Under 1,500 Grams.
复制标题
DOI：
10.3389/fped.2020.558256
复制
发表时间：
2020
影响因子：
2.6
通讯作者：
Singh Y
中科院分区：
文献类型：
--
作者：
Fraisse A;Bautista-Rodriguez C;Burmester M;Lane M;Singh Y
持续性动脉导管未闭（PDA）在早产儿中非常常见，尤其是在极早产儿中。尽管在这些易感婴儿的治疗方面取得了重大进展，但在PDA的治疗方面还没有达成共识——我们应该何时治疗，我们应该治疗谁，我们应该如何治疗，事实上，我们应该如何定义血流动力学意义重大的PDA也没有达成共识。非甾体抗炎药（NSAIDs）仍然是关闭PDA的一线治疗方法，成功率中等。据报道，扑热息痛是一种安全且同样有效的治疗PDA闭合的药物。然而，在推荐扑热息痛作为早产儿PDA的标准治疗之前，还需要对其在极低出生体重婴儿中的长期安全性和有效性进行进一步的研究。手术结扎PDA并非没有增加死亡和合并症的风险。最近，对于包括极低出生体重婴儿在内的早产儿，经皮经导管闭合PDA的研究已经引起了极大的兴趣。与手术结扎相比，经导管PDA闭合在技术上是可行的，具有较高的PDA闭合成功率和可接受的并发症发生率。许多中心已经报告了早期和中期随访结果。然而，在将其作为极低出生体重婴儿PDA闭合的新护理标准之前，它们需要在前瞻性设计良好的研究和随机对照试验中进一步测试，将该技术的结果和结果与目前的治疗策略（包括药物治疗）进行比较。
Persistent patent ductus arteriosus (PDA) is very common in preterm infants, especially in extremely preterm infants. Despite significant advances in management of these vulnerable infants, there has been no consensus on management of PDA—when should we treat, who should we treat, how should we treat and in fact there is no agreement on how we should define a hemodynamically significant PDA. Medical management with non-steroidal anti-inflammatory drugs (NSAIDs) remains the first line of therapy with moderate success rate in closing the PDA. Paracetamol has been reported to be a safe and equally effective medical therapy for closure of PDA. However, additional studies on its long-term safety and efficacy in extremely low birth weight infants are needed before paracetamol can be recommended as standard treatment for a PDA in preterm infants. Surgical ligation of PDA is not without an increased risk of mortality and co-morbidities. Recently, there has been a significant interest in percutaneous transcatheter closure of PDA in preterm infants, including extremely low birth weight infants. Transcatheter PDA closure in preterm ELBW infants is technically feasible with high PDA occlusion success rates and acceptable complication rates as compared to surgical ligation. Many centers have reported promising early- and mid-term follow-up results. However, they need to be further tested in the prospective well-designed studies and randomized controlled trials comparing the results and outcomes of this technique with current treatment strategies including medical treatment before they can be used as the new standard of care for PDA closure in extremely low birth weight infants.
登录
查看更多内容
影响因子：
2.9
作者：
Kaempf, J. W.;Wu, Y. X.;Grunkemeier, G.
通讯作者：
Grunkemeier, G.
影响因子：
2.9
作者：
Benitz, W. E.
通讯作者：
Benitz, W. E.
影响因子：
5.1
作者：
Janz-Robinson, Estella M.;Badawi, Nadia;Abdel-Latif, Mohamed E.
通讯作者：
Abdel-Latif, Mohamed E.
影响因子：
8
作者：
Chorne, Nancy;Leonard, Carol;Clyman, Ronald I.
通讯作者：
Clyman, Ronald I.
影响因子：
5.1
作者：
Kabra, Nandkishor S.;Schmidt, Barbara;Fanaroff, Avroy
通讯作者：
Fanaroff, Avroy