Abstract
68 VLBW neonates (<1200 grams)with severe RDS(FiO2 requirement >.50, IMV and a positive CXR)were evaluated for a PDA by exam, echocardiography, pulsed doppler and flush aortography. 3 different clinical courses were noted. Group I(19% mean BW 888.7gms) demonstrated early irreversible CR failure and death within 24 hours despite attempts at medical closure of PDA with indomethacin(.2mg/kg po). Group II(62%)had severe RDS and PDA and medical or surgical ligation was performed in all of the neonates when the PDA was documented and deemed clinically significant. Group III(19%)had severe RDS without a documentable PDA. The overall study group survival was 59.9%. Survival in Groups II and III was 67% and 84.7% respectively. A comparison between these groups is listed below:
The data show that the presence of RDS with or without PDA in VLBW neonates is associated with prolonged requirements of assisted ventilation and the development of BPD. However, a smaller group of VLBW neonates with severe RDS and PDA, despite early manipulation of the PDA will still succumb in less than 24 hours.
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Cook, L., Shott, R., Wilkerson, S. et al. 1278 THREE CLINICAL PATTERNS OF RDS-PDA IN VERY LOW BIRTHWEIGHT NEONATES (VLBW). Pediatr Res 15 (Suppl 4), 656 (1981). https://doi.org/10.1203/00006450-198104001-01307
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DOI: https://doi.org/10.1203/00006450-198104001-01307