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Preterm infants who later require duct ligation show different vital signs and pH in early postnatal life
Author(s) -
Steiner Manuel,
SalzerMuhar Ulrike,
Swoboda Vanessa,
Unterasinger Lukas,
Baumgartner Sigrid,
Waldhoer Thomas,
Langgartner Michaela,
KlebermassSchrehof Katrin,
Berger Angelika
Publication year - 2015
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.12814
Subject(s) - medicine , ductus arteriosus , ligation , gestational age , vital signs , ibuprofen , anesthesia , heart rate , small for gestational age , pediatrics , logistic regression , blood pressure , gestation , cardiology , pregnancy , biology , pharmacology , genetics
Aim 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). Conclusion 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.