Use of Paracetamol for Treatment of Patent Ductus Arteriosus in Preterm Neonates: A 5-Year Experience From a Tertiary Hospital in India.

IF 1.7 4区医学 Q2 PEDIATRICS

Indian pediatrics Pub Date : 2024-07-15 Epub Date: 2024-05-25

Deepika Kainth, Satya Prakash, Vivek Kumar, R Dhinakaran, Ankit Verma, Ramesh Agarwal

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引用次数: 0

Abstract

Objective: We evaluated ductal closure rates in preterm neonates with hemodynamically significant patent ductus arteriosus (hsPDA) who received paracetamol (PCM) as first-line therapy.

Methods: In this retrospective chart review, we included inborn preterm (< 37 weeks) neonates (January 2017-December 2021) with hsPDA (ductal diameter > 1.5 mm and left atrium-to-aortic root ratio (La/Ao > 1.4) who were treated with oral or intravenous PCM. Primary outcome was hsPDA closure (defined as small or no PDA) following 3-day treatment. Secondary outcomes were need for retreatment and surgical ligation, pulmonary hypertension (PH), and in-hospital morbidities.

Results: Out of 2784 preterm birth, 117 neonates were diagnosed with hsPDA. Out of 96 neonates who received PCM in the first course, 20 died before the completing the first course. The median (IQR) gestation and birth weight of neonates who received PCM were 28 (26, 29) weeks and 841 (714, 1039) g, respectively. Out of 76 neonates who completed treatment with first course of PCM (57 intravenous, 19 oral), 43 (56.6%) achieved successful closure and five (6.6%) developed PH. Out of 14 neonates who received a second course of PCM, 10 achieved closure of hsPDA while one neonate expired.

Conclusion: Paracetamol is associated with successful closure of hsPDA in 56.6% of preterm neonates after one course and 70% of premies after two courses.

本刊更多论文

使用扑热息痛治疗早产新生儿动脉导管未闭：印度一家三甲医院的五年经验。

目的：我们评估了接受扑热息痛（PCM）作为一线治疗的具有血流动力学意义的动脉导管未闭（hsPDA）早产新生儿的导管闭合率：在这项回顾性病历审查中，我们纳入了接受口服或静脉注射 PCM 治疗的患有 hsPDA（动脉导管直径 > 1.5 mm 且左心房与主动脉根部比值（La/Ao > 1.4））的新生早产儿（< 37 周）（2017 年 1 月至 2021 年 12 月）。主要结果是 3 天治疗后 hsPDA 关闭（定义为 PDA 较小或无 PDA）。次要结果是是否需要再次治疗和手术结扎、肺动脉高压（PH）和院内发病率：结果：在2784名早产儿中，有117名新生儿被诊断出患有hsPDA。在接受 PCM 第一疗程的 96 名新生儿中，有 20 名在完成第一疗程前死亡。接受 PCM 治疗的新生儿的妊娠期中位数（IQR）和出生体重分别为 28（26，29）周和 841（714，1039）克。在 76 名完成首个 PCM 疗程（57 名静脉注射，19 名口服）的新生儿中，43 名（56.6%）成功闭合，5 名（6.6%）出现 PH。在接受第二个疗程 PCM 治疗的 14 名新生儿中，10 名成功关闭了 hsPDA，1 名新生儿死亡：结论：56.6% 的早产新生儿在接受一个疗程的扑热息痛治疗后可成功关闭 hsPDA，70% 的早产儿在接受两个疗程的扑热息痛治疗后可成功关闭 hsPDA。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Indian pediatrics 医学-小儿科

CiteScore

3.30

自引率

8.70%

发文量

344

审稿时长

3-8 weeks

期刊介绍： The general objective of Indian Pediatrics is "To promote the science and practice of Pediatrics." An important guiding principle has been the simultaneous need to inform, educate and entertain the target audience. The specific key objectives are: -To publish original, relevant, well researched peer reviewed articles on issues related to child health. -To provide continuing education to support informed clinical decisions and research. -To foster responsible and balanced debate on controversial issues that affect child health, including non-clinical areas such as medical education, ethics, law, environment and economics. -To achieve the highest level of ethical medical journalism and to produce a publication that is timely, credible and enjoyable to read.