[First SIBEN clinical consensus: diagnostic and therapeutic approach to patent ductus arteriosus in premature newborns].
OBJECTIVE
To report the process and results of the first neonatal clinical consensus of the Ibero-American region.


METHODS
Two recognized experts in the field (Clyman and Van Overmeire) and 45 neonatologists from 23 countries were invited for active participation and collaboration. We developed 46 questions of clinical-physiological relevance in all aspects of patent ductus arteriosus (PDA). Guidelines for consensus process, literature search and future preparation of educational material and authorship were developed, reviewed and agreed by all. Participants from different countries were distributed in groups, and assigned to interact and work together to answer 3-5 questions, reviewing all global literature and local factors. Answers and summaries were received, collated and reviewed by 2 coordinators and the 2 experts. Participants and experts met in Granada, Spain for 4.5 h (lectures by experts, presentations by groups, discussion, all literature available).


RESULTS
31 neonatologists from 16 countries agreed to participate. Presentations by each group and general discussion were used to develop a consensus regarding: general management, availability of drugs (indomethacin vs. ibuprofen), costs, indications for echo/surgery, etc. Many steps were learnt by all present in a collaborative forum.


CONCLUSIONS
This first consensus group of Ibero-American neonatologists SIBEN led to active and collaborative participation of neonatologists of 16 countries, improved education of all participants and ended with consensus development on clinical approaches to PDA. Furthermore, it provides recommendations for clinical care reached by consensus. Additionally, it will serve as a useful foundation for future SIBEN Consensus on other topics and it could become valuable as a model to decrease disparity in care and improve outcomes in this and other regions.
Golombek
S G
SG
SIBEN, Sociedad Iberoamericana de Neonatología, The Regional Neonatal Center, Maria Fareri Children's Hospital at Westchester Medical Center/New York Medical College-Valhalla, Valhalla, New York 10595, USA. sergio_golombek@nymc.edu
Sola
A
A
Baquero
H
H
Borbonet
D
D
Cabañas
F
F
Fajardo
C
C
Goldsmit
G
G
Lemus
L
L
Miura
E
E
Pellicer
A
A
Pérez
J M
JM
Rogido
M
M
Zambosco
G
G
van Overmeire
B
B
D000367:Age Factors; D001927:Brain Diseases / Q000209:etiology; D003362:Cost-Benefit Analysis; D016861:Cyclooxygenase Inhibitors / Q000627:therapeutic use; D004232:Diuretics / Q000627:therapeutic use; D004374:Ductus Arteriosus, Patent / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy*; D004750:Enteral Nutrition; D005440:Fluid Therapy; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use; D007213:Indomethacin / Q000627:therapeutic use; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000175:diagnosis* / Q000628:therapy*; D014463:Ultrasonography; D014882:Water-Electrolyte Balance
D016861:Cyclooxygenase Inhibitors; D004232:Diuretics; D007052:Ibuprofen; D007213:Indomethacin