Premium
Trends in patent ductus arteriosus ligation in neonates and changes in outcomes: A 10‐year multicenter experience
Author(s) -
Wang Huanhuan,
Jain Amish,
Weisz Dany E.,
Moraes Theo J.
Publication year - 2021
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.25576
Subject(s) - medicine , ductus arteriosus , ligation , incidence (geometry) , bronchopulmonary dysplasia , pediatrics , birth weight , surgery , gestational age , retrospective cohort study , anesthesia , pregnancy , physics , biology , optics , genetics
Rationale The management of neonates with patent ductus arteriosus (PDA) has changed over time. Methods We conducted a single‐city, retrospective review of neonates who underwent PDA ligation over a 10‐year time period and compared infants from the first 5 years to the second 5 years to evaluate how clinical characteristics changed over this time. Results Infants from the second 5‐year epoch were older at time of ligation (38 vs. 30 days), had a higher ligation weight (1432 vs. 1121 g) and a lower incidence of postligation cardiac syndrome (1.9% vs. 11.5%). No differences in mortality, length of hospital‐stay or major morbidities were seen. Compared to neonates who underwent PDA ligation at ≤28 days of life, those with a ligation age >28 days had a higher ligation weight (1421 vs. 1039 g), a higher proportion of COX inhibitor use (92.5% vs. 83.8%), and a higher incidence of moderate‐severe bronchopulmonary dysplasia (BPD) (60.4% vs. 44.4%). Only 10.7% (25/233) patients were evaluated by laryngoscopy, in which the incidence of vocal cord paralysis (VCP) was 36.0%; 2 patients were clinically diagnosed with VCP for a total 4.7% incidence of VCP (11/233). Conclusions Over the 10 years examined, neonates underwent PDA ligation at an older age in the second 5‐year time period; this change was not associated with a change in the incidence of major morbidities. Ligation age >28 days was associated with an increase incidence of moderate‐severe BPD. The overall incidence of documented VCP post‐PDA ligation was relatively low but was seen in over 1/3 who were evaluated by laryngoscopy.