title: Impact of patient selection on outcomes of PDA in very low birth weight infants.
abstract: OBJECTIVE
  The aim of this study was to observe whether our patient selection maximized the benefits of PDA ligation by comparing the outcomes in a surgically ligated group of PDA to a medically closed group.
  
  
  METHODS
  If a hemodynamically significant ductus arteriosus (HSDA) was found to meet both clinical and echocardiographic criteria (stage≥3), as proposed by NcNamara and Hellman, medical treatment was initiated with oral ibuprofen (maximum 2 courses). If the PDA of these patients failed to close medically, timed surgical closure was performed.
  
  
  RESULTS
  Medical treatment was effective in 75 (72%) cases, and 29 (28%) patients required surgical ligation. The mean gestational age and birth weight were each significantly lower and the initial PDA shunt size was significantly larger in the surgically treated group. Additionally, the mean durations of mechanical ventilation, oxygen dependence and hospital admission were significantly longer in the surgically ligated group. However, our logistic regression analysis demonstrated no statistically significant difference in the outcomes of hospitalization (CLD, NEC, ARF, sepsis, IVH, ROP, PVL and death) between the two groups.
  
  
  CONCLUSIONS
  Comprehensive HSDA patient selection may maximize the benefits of timed PDA ligation without adverse outcomes in very low birth weight infants.
authors.affiliation: Department of Pediatrics, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: YoungAh
authors.initials: Y
authors.lastname: Youn
authors.forename: Ju-Young
authors.initials: JY
authors.lastname: Lee
authors.forename: Jung Hyun
authors.initials: JH
authors.lastname: Lee
authors.forename: So-Young
authors.initials: SY
authors.lastname: Kim
authors.forename: In Kyung
authors.initials: IK
authors.lastname: Sung
authors.forename: Jae Young
authors.initials: JY
authors.lastname: Lee
mesh_terms: D000284:Administration, Oral; D001724:Birth Weight / Q000502:physiology; D004374:Ductus Arteriosus, Patent / Q000188:drug therapy* / Q000601:surgery*; D004452:Echocardiography; D005260:Female; D005865:Gestational Age; D006801:Humans; D007052:Ibuprofen / Q000008:administration & dosage / Q000627:therapeutic use*; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008026:Ligation; D016015:Logistic Models; D008297:Male; D018579:Patient Selection; D056910:Republic of Korea; D016896:Treatment Outcome
chemical_list: D007052:Ibuprofen