Abstract
Introduction Many neonatal centers offer surgical ligation of patent ductus arteriosus (PDA) after
two failed courses of pharmacologic therapy. This study compares health status of
extremely premature (< 28 weeks gestation) neonates who failed medical therapy at
the time of their second course of medical treatment versus operation.
Materials and Methods A retrospective chart review was performed on neonates born at less than 28 weeks
gestation who underwent PDA ligation after two rounds of medical therapy over a 7.5-year
period. Measurements of health status at the time of the second course of medical
therapy and the time of operation were compared.
Results Neonates (n = 34) required less fraction of inspired oxygen (33.5 ± 12.9% vs. 48.5 ± 24%, p < 0.0001), had lower mean airway pressure (7.5 ± 1.9 vs. 9.1 ± 2.4 mm Hg, p < 0.0001), and were less likely to require vasopressor support (16.7 vs. 60%, p = 0.0126) at the time of the start of second course than at surgery.
Conclusion Our study suggests that extremely premature neonates show a decline in cardiopulmonary
reserve between a second course of medical therapy and surgical intervention.
Keywords
extremely premature - neonate - patent ductus arteriosus - ligation - cardiopulmonary
reserve
