title: Preterm infants who later require duct ligation show different vital signs and pH in early postnatal life.
abstract: OBJECTIVE
  The study investigated early postnatal vital signs in very low birthweight (VLBW) infants who later developed patent ductus arteriosus (PDA). We hypothesised that the early postnatal course of vital signs and blood gas variables might differ between infants whose PDA closed spontaneously, those who responded to ibuprofen and those who later required PDA ligation.
  
  
  METHODS
  We analysed computerised records of VLBW infants born <28 weeks of gestational age, including vital signs, arterial pH values and echocardiographic data from the first postnatal days.
  
  
  RESULTS
  In total, 104 infants were included in the study. In the group of infants born <26 weeks of gestational age and requiring ibuprofen for PDA (n = 34), 12 infants ultimately required surgical ligation. Infants requiring ligation showed significantly lower oxygen saturation (p = 0.019), mean blood pressure (p = 0.034) and higher heart rate fluctuation ranges (p = 0.040) in the first five postnatal days than those who responded to ibuprofen. In multivariable logistic regression analysis, lower pH values in the first 48 h predicted the subsequent requirement for ligation independent of gestational age (p = 0.004).
  
  
  CONCLUSIONS
  Patients <26 weeks of gestational age requiring PDA ligation showed significant differences in the course of vital signs and pH during the first days of life.
authors.affiliation: Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.
authors.forename: Manuel
authors.initials: M
authors.lastname: Steiner
authors.forename: Ulrike
authors.initials: U
authors.lastname: Salzer-Muhar
authors.forename: Vanessa
authors.initials: V
authors.lastname: Swoboda
authors.forename: Lukas
authors.initials: L
authors.lastname: Unterasinger
authors.forename: Sigrid
authors.initials: S
authors.lastname: Baumgartner
authors.forename: Thomas
authors.initials: T
authors.lastname: Waldhoer
authors.forename: Michaela
authors.initials: M
authors.lastname: Langgartner
authors.forename: Katrin
authors.initials: K
authors.lastname: Klebermass-Schrehof
authors.forename: Angelika
authors.initials: A
authors.lastname: Berger
mesh_terms: D001784:Blood Gas Analysis; D004374:Ductus Arteriosus, Patent / Q000097:blood / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D062071:Infant, Extremely Premature / Q000502:physiology*; D007231:Infant, Newborn; D008026:Ligation; D008297:Male; D012189:Retrospective Studies; D055986:Vital Signs
keywords: Ligation; Patent ductus; Preterm; Vital signs