%0 Journal Article
%T Failure of a repeat course of cyclooxygenase inhibitor to close a PDA is a risk factor for developing chronic lung disease in ELBW infants
%A Lynda Adrouche-Amrani
%A Robert S Green
%A Karen M Gluck
%A Jing Lin
%J BMC Pediatrics
%D 2012
%I BioMed Central
%R 10.1186/1471-2431-12-10
%X Medical information on 138 infants with birth weight (BW) < 1000 gm who survived for > 48 hours was retrieved. Clinical characteristics and outcomes of patients whose PDAs closed with COI were compared with those who did not close.Of the 138 patients, 112 survived to discharge. Eighty (71.4%) of those who survived received 1-3 courses of COI treatment for a symptomatic PDA. A total of 32 (40%) failed COI treatment and underwent PDA ligation. Multivariable logistic regression analysis suggests that the observed differences in the outcomes in infants with or without symptomatic PDA can be explained by the babies with symptomatic PDA being more immature and sicker. No significant difference was seen in the incidence of chronic lung disease (CLD) in infants whose PDA was treated medically versus those who failed medical treatment and then underwent ligation. However, after adjusting for disease severity and other known risk factors, the odds ratio of developing CLD for surviving babies with a persistent PDA compared to those whose PDA was successfully closed with 1-2 courses of COI is 3.24 (1.07-9.81; p = 0.038).When successfully treated, PDA in ELBW infants did not contribute significantly to the adverse outcomes such as CLD, retinopathy of prematurity (ROP) and age at discharge. This suggests that it is beneficial for a hemodynamically significant PDA to be closed. The failure of a repeat course of COI to close a PDA is a major risk factor for developing CLD in ELBW infants.Spontaneous closure of the ductus arteriosus (DA) usually occurs within hours to days after birth in term infants. However, the incidence of failure of DA closure in premature infants ranges from 10% to 60% depending on the gestational age, birth weight and diagnostic criteria used [1,2]. In extremely low birth weight (ELBW) infants (birth weight less than 1000 grams), only 34% have a spontaneous permanent closure of the DA [3]. A significant left-to-right shunt through the PDA may increase morbidi
%U http://www.biomedcentral.com/1471-2431/12/10