Effect of circulatory management of extremely low birth weight infants on patent ductus arteriosus

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  • 超低出生体重児の循環管理が未熟児動脈管開存症に与える影響

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<p> Background: Patent ductus arteriosus is one of the complications in extremely low birth weight infants and affects their mortality and neurodevelopmental outcomes. We investigated the effects of a change in circulatory management on morbidity such as patent ductus arteriosus and long-term neurological prognosis of extremely low birth weight infants. Methods: We identified extremely low birth weight infants between 2005 and 2017 and classified them into two groups by the treatment timing, namely before and after the introduction of prophylaxis administration of indomethacin. The infants born in other hospitals and those with congenital malformations were excluded. We compared maternal, neonatal, and treatment details, mortality, complications, and the developmental status between the two groups. Results: There were 156 and 220 infants in the early and late groups, respectively. The volume of patent ductus arteriosus surgery significantly increased in the late group. Multivariate analysis showed that indomethacin administration, fluid dose, steroid use in the acute phase, and the use of two sedatives significantly increased in the late group. There were no differences in mortality and developmental delay between the two groups. Conclusions: The change in circulatory management may have caused an increase in patent ductus arteriosus surgery for extremely low birth weight infants.</p>

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