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Current Status of Therapeutic Strategies for Patent Ductus Arteriosus in Very- Low- Birth- Weight Infants in Korea

Authors
Lee, Jin A.Kim, Myo-JingOh, SoheeChoi, Byung Min
Issue Date
10월-2015
Publisher
KOREAN ACAD MEDICAL SCIENCES
Keywords
Very-Low-Birth-Weight Infant; Patent Ductus Arteriosus; Treatment; Korea
Citation
JOURNAL OF KOREAN MEDICAL SCIENCE, v.30, pp.S59 - S66
Indexed
SCIE
SCOPUS
KCI
Journal Title
JOURNAL OF KOREAN MEDICAL SCIENCE
Volume
30
Start Page
S59
End Page
S66
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/92291
DOI
10.3346/jkms.2015.30.S1.S59
ISSN
1011-8934
Abstract
This study aimed to investigate current therapeutic strategies for patent ductus arteriosus (PDA) in very-low-birth-weight (VLBW) infants in Korea. A total of 2,254 VLBW infants among 2,386 from Korean Neonatal Network cohort born from January 2013 to June 2014 were included. No PDA was seen for 1,206 infants (53.5%) and the infants diagnosed or treated for PDA were 1,048 infants (46.5%). The proportion of infants with PDA was decreased according to the increase in gestational age (GA) and birthweight. Infants with PDA were divided into groups according to the therapeutic strategies of PDA: prophylactic treatment (PT, n= 69, 3.1%), pre-symptomatic treatment (PST, n= 212, 9.4%), symptomatic treatment (ST, n= 596, 26.4%), and conservative treatment (CT, n= 171, 7.6%). ST was the most preferred treatment modality for preterm PDA and the proportion of the patients was decreased in the order of PST, CT, and PT. Although ST was still the most favored treatment in GA< 24 weeks group, CT was more preferred than PST or ST when compared with GA >= 32 weeks group [CT vs. PST, OR 5.3, 95% CI 1.56-18.18; CT vs. ST, OR 2.9, 95% CI 1.03-8.13]. A total of 877 infants (38.9%) received pharmacological or surgical treatment about PDA, and 35.5% (801 infants) received pharmacological treatment, mostly with ibuprofen. Seventy-six infants (3.4%) received primary ligation and 8.9% (201 infants) received secondary ligation. Diverse treatment strategies are currently used for preterm PDA in Korea. Further analyses of neonatal outcomes according to the treatment strategies are necessary to obtain a standardized treatment guideline for preterm PDA.
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