title: Early or late surgical ligation of medical refractory patent ductus arteriosus in premature infants.
abstract: Optimal time to surgical ligation of patent ductus arteriosus (PDA) in very-low-birth-weight (< 1500 g) premature infants remains an area of controversy. We compared the outcomes of early or late ligation of medical refractory PDA in very-low-birth-weight premature infants. Fifty-six infants underwent surgical closure of PDA after failure of or having contraindications to medical treatment. Thirteen infants were in the early ligation (< or = 14 days) and 43 in the late ligation (> 14 days) groups. Basic clinical features, major morbidity of prematurity and mortality were compared. Clinical features and major outcomes were similar. The early ligation group had earlier onset of symptomatic PDA (5.7 +/- 1.6 days vs. 8.1 +/- 3.6 days, p = 0.024), and fewer days of total parenteral nutrition (TPN) (39.6 +/- 13.9 days vs. 60.4 +/- 31.4 days, p = 0.025) and ventilator use (11.1 +/- 6.7 days vs. 18.6 +/- 10.5 days, p = 0.019). Early ligation of medical refractory PDA in very-low-birth-weight premature infants improves enteral feeding tolerance and reduces TPN and ventilator use, but long-term benefits need further investigation.
authors.affiliation: Department of Pediatrics, Children's Hospital, Changhua Christian Hospital, Changhua, College of Health Sciences, Chang Jung Christian University, Tainan, Taiwan.
authors.forename: Chien-Chou
authors.initials: CC
authors.lastname: Hsiao
authors.forename: Jen-Tien
authors.initials: JT
authors.lastname: Wung
authors.forename: Lon-Yen
authors.initials: LY
authors.lastname: Tsao
authors.forename: Weng-Cheng
authors.initials: WC
authors.lastname: Chang
mesh_terms: D016861:Cyclooxygenase Inhibitors / Q000627:therapeutic use; D004374:Ductus Arteriosus, Patent / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D019102:Infant, Very Low Birth Weight; D008026:Ligation / Q000401:mortality; D008297:Male; D010289:Parenteral Nutrition, Total; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D016861:Cyclooxygenase Inhibitors; D007213:Indomethacin