Abstract
A retrospective and prospective study was undertaken to determine whether early ligation of PDA (7 days of age or less) resulted in a decreased incidence of BPD and shorter period of ventilatory support in infants with RDS and cardiopulmonary failure.
The diagnosis of a PDA was made on clinical grounds (murmur, hyperactive precordlum and pulses) with several infants having aortographic and/or echocardiographic confirmation of a PDA prior to surgery. The early group consisted of 16 infants (B.W. 1240 gms, G.A. 29.2 weeks), operated on at a mean of 4.8 days, while the late group consisted of 20 infants (B.W. 1175 gms, G.A. 28.5 weeks) operated on at 14.4 days.
Infants developing clinical and X-ray evidence of BPD (15 of 36, 41%) received assisted ventilation for 8.2 days preoperatively and 16.6 days postoperatively. Infants not developing BPD received assisted ventilation for 5.9 days preoperatively and 3.0 days postoperatively. Infants operated on early (≤ 7 days) received 4.7 days of ventilatory support postoperatively of whom only 25% (4/16) developed BPD. Infants operated beyond 7 days required 16.6 days of ventilatory assistance postoperatively. Among this group 55% developed BPD (11/20). The combined mortality was 36% (13/36) with 35% (7/20) in the late group and 37% (6/16) in the early group. There was 1 perioperative death and 12 late deaths. These data indicate that while there was no statistical difference in mortality, there was a significant decrease in total duration of ventilatory time and BPD in the early treated group.
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Whitaitt, L., Baden, M., Traugott, R. et al. EARLY LIGATION OF PDA, EFFECT ON BPD AND POSTOPERATIVE VENTILATOR TIME. Pediatr Res 11, 402 (1977). https://doi.org/10.1203/00006450-197704000-00199
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DOI: https://doi.org/10.1203/00006450-197704000-00199