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KMID : 0390320160260020049
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Chungbuk Medical Journal
2016 Volume.26 No. 2 p.49 ~ p.56
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The Determinants of Medication or Surgical Treatment of Premature Infants with Patent Ductus Arteriosus
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Oh A-Rum
Jung Jae-Yeob
Han Heon-Seok
Lee Ji-Hyuk
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Abstract
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Purpose : Patent ductus arteriosus (PDA) is a condition that can have a significant impact on morbidity and mortality and the prognosis of premature infants. Currently medication and surgical treatment for the treatment of PDA are used but the exact criteria and appropriate timing of surgery remains controversial. This study was designed to investigate the basis and timing of appropriate surgical treatment of preterm infants with PDA.
Materials and Methods : Initially 77 preterm infants (gestation age below 35 weeks) with PDA (male 39, female 38) were enrolled and we excluded 3 infants with only surgery and 2 infants with spontaneous closure without treatment in chungbuk national university hospital. Then 72 infants devided two groups, medication only group and surgery after medication group. We compared two groups with demographic data, treatment methods, results of treatment and complication by restrospective analysis of medical records.
Results : The Mean gestational age was 29+1 weeks and mean birth weight was 1191.2±363.7 g. Initial size of PDA were not different (2.9±1.0 mm vs. 3.2±1.0 mm). But, 5 min APGAR score were higher in medication only group (8.2 points vs. 7.2 points), the rate of RDS (surfactant) were lower in medication only group (79.4% vs. 95.2%). In medication only group, duration of ventilator were shorter (11.7 days vs. 29.3 days), and hospitalization time were shorter (69.7 days vs. 97.5 days), The incidence of bronchopulmonary dysplasia (BPD) is lower in medication only group (47.1% vs. 85.7%).
Conclusion : Patients in surgery after medication group had lower PAGAR score, large PDA size after first medication and high incidence of respiratory distress syndrome. Therefore, surgical treatment of PDA is considered if preterm infants have poor condition after birth, respiratory difficulty or poor response of initial medical treatment.
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KEYWORD
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Prematurity, patent ductus arteriosus, ibuprofen, surgical treatment
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