ABSTRACT:
Introduction: In the new-born, persistent patent ductus arteriosus is associated with significant morbidity and mortality.
Normally at birth, ductus arteriosus contracts causing intraluminal ischemic hypoxia that ultimately leads to closure and remodelling
of the ductus. Currently, the medical management of PAD is based on the use of non-selective inhibitors of the cyclooxygenase enzyme that
participates in the synthesis of prostaglandins, especially indomethacin, acetaminophen, and ibuprofen, which promote closure of the communication
by up to 70% -93%. Materials and methods: Observational, retrospective, and analytical study in which records from the EpicLatino database were used.
Results: 1243 patients were obtained, 52% of patients received some type of treatment and, 171 preterm patients received treatment with acetaminophen,
with an increase in the trend in its use from the year 2015 to 2020. Conclusions: More treatment was used as lower the gestational age was. The use of
indomethacin and ibuprofen has decreased from 2015 to 2020 due to the adverse effects they cause compared to acetaminophen.
KEYWORDS:
Ductus Arteriosus, Patent; altitude; Heart Defects, Congenital; Cardiovascular Abnormalities; Neonatology.
REFERENCES :
1) Lee JA, Kim MJ, Oh S, Choi BM. Current status of therapeutic strategies for patent ductus arteriosus in very-low-birth-weight infants in Korea. J Korean Med Sci 2015;30:Suppl 1:S59-S66.
2) Hundscheid T, El-Khuffash A, McNamara PJ, de Boode WP. Survey highlighting the lack of consensus on diagnosis and treatment of patent ductus arteriosus in prematurity. Eur J Pediatr 2022;181:2459-68.
3) Jansen EJS, Hundscheid T, Onland W, Kooi EMW, Andriessen P, de Boode WP. Factors associated with benefit of treatment of patent ductus arteriosus in preterm infants: a systematic review and meta analysis. Front Pediatric 2021;9:626262.
4) Sathanandam S, Whiting S, Cunningham J et al. Practice variation in the management of patent ductus arteriosus in extremely low birth weight infants in the United States: Survey results among cardiologists and neonatologists. Congenital Heart Dis. 2019Jan;14(1):6-14
5) Sheffield K, Mitra S. Variation in diagnostic criteria for hemodynamically significant PDA in randomized clinical trials: A systematic review. Poster session presented at: 3rd Congress of joint European Neonatal Societies; 2019 Sep 17-21; Maastricht, the Netherlands.
6) Benitz WE; Committee on Fetuses and Newborns; American Academy of Pediatrics. Patent ductus arteriosus in preterm infants. Pediatrics 2016;137(1):e20153730.
7) Gross R, Hubbard JP. Surgical ligation of a patent ductus arteriosus: Report of first successful case. NEVER. 1939;112(8):729–731. doi:10.1001/jama.1939.02800080049011.
8) WalehN, Seidner S, McCurnin D, et al. Anatomic closure of the premature patent ductus arteriosus: The role of CD14+/CD163+ mononuclear cells and VEGF in neointimal mound formation. Pediatric Res 2011; 70:332.
9) Sung SI, Lee MH, Park WS. Nonintervention is not noninferior to oral ibuprofen for treatment of patent ductus arteriosus-reply. JAMA Pediatric [Internet]. 2021;175(4):430–1. Available
at: http://dx.doi.org/10.1001/jamapediatrics.2020.5329
10) Hamrick SEG, Sallmon H, Rose AT, Porras D, Shelton EL, Reese J, et al. Patent ductus arteriosus of the preterm infant. Pediatrics [Internet]. 2020;146(5):e20201209. Available at: http://dx.doi.org/10.1542/peds.2020-1209
11) Li JJ, Liu Y, Xie SY, Zhao GD, Dai T, Chen H, et al. Newborn screening for congenital heart disease using echocardiography and follow-up at high altitude in China. Int J Cardiol [Internet]. 2019;274:106–12. Available at: http://dx.doi.org/10.1016/j.ijcard.2018.08.102
12) Ngo S, Profit J, Gould JB, Lee HC. Trends in patent ductus arteriosus diagnosis and management for very low birth weight infants. Pediatrics [Internet]. 2017;139(4):e20162390. Available in:http://dx.doi.org/10.1542/peds.2016-2390