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The Ideal Timing of Bedside Surgical Ligation of Patent Ductus Arteriosus in Premature Babies Less Than 30 Gestational Weeks

OBJECTIVE: The aim of our study is to determine the relationship between exposure to hemodynamically significant patent ductus arteriosus and morbidities in premature babies, the optimal number of pharmacologic treatment cycles, and ideal ductus ligation timing. MATERIALS AND METHODS: The study was...

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Autores principales: Umut Zübarioğlu, Adil, Yıldırım, Özgür, Zeybek, Cenap, Balaban, İsmail, Aliyev, Bahruz, Yazıcıoğlu, Volkan, Tutak, Ercan, Dursun, Mesut, Türkoğlu Ünal, Ebru, Kara, Nursu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Turkish Pediatrics Association 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8890320/
https://www.ncbi.nlm.nih.gov/pubmed/35929851
http://dx.doi.org/10.5152/TurkArchPediatr.2021.21010
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author Umut Zübarioğlu, Adil
Yıldırım, Özgür
Zeybek, Cenap
Balaban, İsmail
Aliyev, Bahruz
Yazıcıoğlu, Volkan
Tutak, Ercan
Dursun, Mesut
Türkoğlu Ünal, Ebru
Kara, Nursu
author_facet Umut Zübarioğlu, Adil
Yıldırım, Özgür
Zeybek, Cenap
Balaban, İsmail
Aliyev, Bahruz
Yazıcıoğlu, Volkan
Tutak, Ercan
Dursun, Mesut
Türkoğlu Ünal, Ebru
Kara, Nursu
author_sort Umut Zübarioğlu, Adil
collection PubMed
description OBJECTIVE: The aim of our study is to determine the relationship between exposure to hemodynamically significant patent ductus arteriosus and morbidities in premature babies, the optimal number of pharmacologic treatment cycles, and ideal ductus ligation timing. MATERIALS AND METHODS: The study was a retrospective single-center study conducted in a 3-year period between July 2017 and June 2020. Premature babies, born ≤30 weeks of gestation and transferred to our unit for bedside ductus ligation, were included in the study. The subjects were divided into 2 groups; Group A consisted of the patients who received ≥3 pharmacologic treatment cycles, and group B consisted of the patients who received ≤2 cycles. The groups were compared according to preoperative and postoperative features. The main outcome of the study was the presence of severe bronchopulmonary dysplasia. The secondary outcomes were specified as the length of stay in the neonatal intensive care unit and the duration of invasive mechanical ventilation (MV). RESULTS: The study group consisted of 24 patients. There were 10 patients in group A and 14 patients in group B. The mean gestational week and the mean birthweight were found to be 26,7 ± 2.2 weeks and 928 ± 190 g, respectively. The incidence of severe bronchopulmonary dysplasia was significantly higher in group A (70% vs. 14.3%; P = .019). Post-ligation invasive MV, duration, and length of stay in the intensive care unit were found to be significantly longer in group A. None of the patients had hemodynamic disturbances or complications during and after the operation. CONCLUSIONS: Bedside surgical ductus ligation is a safe procedure. Prolonging pharmacologic treatment in order to avoid surgery increases the risk of severe bronchopulmonary dysplasia and prolongs hospital stay.
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spelling pubmed-88903202022-03-14 The Ideal Timing of Bedside Surgical Ligation of Patent Ductus Arteriosus in Premature Babies Less Than 30 Gestational Weeks Umut Zübarioğlu, Adil Yıldırım, Özgür Zeybek, Cenap Balaban, İsmail Aliyev, Bahruz Yazıcıoğlu, Volkan Tutak, Ercan Dursun, Mesut Türkoğlu Ünal, Ebru Kara, Nursu Turk Arch Pediatr Original Article OBJECTIVE: The aim of our study is to determine the relationship between exposure to hemodynamically significant patent ductus arteriosus and morbidities in premature babies, the optimal number of pharmacologic treatment cycles, and ideal ductus ligation timing. MATERIALS AND METHODS: The study was a retrospective single-center study conducted in a 3-year period between July 2017 and June 2020. Premature babies, born ≤30 weeks of gestation and transferred to our unit for bedside ductus ligation, were included in the study. The subjects were divided into 2 groups; Group A consisted of the patients who received ≥3 pharmacologic treatment cycles, and group B consisted of the patients who received ≤2 cycles. The groups were compared according to preoperative and postoperative features. The main outcome of the study was the presence of severe bronchopulmonary dysplasia. The secondary outcomes were specified as the length of stay in the neonatal intensive care unit and the duration of invasive mechanical ventilation (MV). RESULTS: The study group consisted of 24 patients. There were 10 patients in group A and 14 patients in group B. The mean gestational week and the mean birthweight were found to be 26,7 ± 2.2 weeks and 928 ± 190 g, respectively. The incidence of severe bronchopulmonary dysplasia was significantly higher in group A (70% vs. 14.3%; P = .019). Post-ligation invasive MV, duration, and length of stay in the intensive care unit were found to be significantly longer in group A. None of the patients had hemodynamic disturbances or complications during and after the operation. CONCLUSIONS: Bedside surgical ductus ligation is a safe procedure. Prolonging pharmacologic treatment in order to avoid surgery increases the risk of severe bronchopulmonary dysplasia and prolongs hospital stay. Turkish Pediatrics Association 2021-07-01 /pmc/articles/PMC8890320/ /pubmed/35929851 http://dx.doi.org/10.5152/TurkArchPediatr.2021.21010 Text en © Copyright 2021 by The Turkish Archives of Pediatrics https://creativecommons.org/licenses/by-nc/4.0/Content of this journal is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. (https://creativecommons.org/licenses/by-nc/4.0/)
spellingShingle Original Article
Umut Zübarioğlu, Adil
Yıldırım, Özgür
Zeybek, Cenap
Balaban, İsmail
Aliyev, Bahruz
Yazıcıoğlu, Volkan
Tutak, Ercan
Dursun, Mesut
Türkoğlu Ünal, Ebru
Kara, Nursu
The Ideal Timing of Bedside Surgical Ligation of Patent Ductus Arteriosus in Premature Babies Less Than 30 Gestational Weeks
title The Ideal Timing of Bedside Surgical Ligation of Patent Ductus Arteriosus in Premature Babies Less Than 30 Gestational Weeks
title_full The Ideal Timing of Bedside Surgical Ligation of Patent Ductus Arteriosus in Premature Babies Less Than 30 Gestational Weeks
title_fullStr The Ideal Timing of Bedside Surgical Ligation of Patent Ductus Arteriosus in Premature Babies Less Than 30 Gestational Weeks
title_full_unstemmed The Ideal Timing of Bedside Surgical Ligation of Patent Ductus Arteriosus in Premature Babies Less Than 30 Gestational Weeks
title_short The Ideal Timing of Bedside Surgical Ligation of Patent Ductus Arteriosus in Premature Babies Less Than 30 Gestational Weeks
title_sort ideal timing of bedside surgical ligation of patent ductus arteriosus in premature babies less than 30 gestational weeks
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8890320/
https://www.ncbi.nlm.nih.gov/pubmed/35929851
http://dx.doi.org/10.5152/TurkArchPediatr.2021.21010
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