Evolución de los recién nacidos prematuros con cierre quirúrgico del conducto arterioso

Abstract

Patent ductus arteriosus is common in preterm newborns, and has an incidence inversely proportional to gestational age. The aim of this study is to present the clinical features of a neonatal population, before and after surgical ligation of ductus arteriosus.

Material and methods

This is a retrospective, descriptive study conducted on patients admitted to a Neonatal Intensive Care Unit from January 2011 to January 2015. The patients were classified into three groups: Group 1, including patients who underwent surgical ligation between the 8th and 14th day of life (9 patients); Group 2, patients who underwent surgical ligation from the 15th day to the 21st day of life (28 patients), and Group 3, patients who underwent surgical ligation after 21 days of life. Reported variables were: ductus size, weight, gestational age, weight on day of surgical intervention, days of life at diagnosis, and associated morbidity.

Results

Diagnosis was made early for Group 1, at 6.1 days of life. In the majority of cases, surgical ligation was secondary. Growth velocity increased in Group 3 after surgical ligation, reaching 15.6 g/kg/day, with a previous growth velocity of 12.6 g/kg/d. Mean arterial pressure increased after surgical ligation by 4.6, 7.7, and 6.5 mmHg in Groups 1, 2, and 3, respectively. Patients who were mechanically ventilated before surgical ligation were extubated after a mean of 10.5 days.

Conclusion

Diagnosis was established within a mean of 6.1 days. Almost all (92.8%) of cases, surgical ligation was secondary (after failure of medical treatment). Growth velocity after surgical ligation only increased in Group 3.