The Ideal Timing of Bedside Surgical Ligation of Patent Ductus Arteriosus in Premature Babies Less Than 30 Gestational Weeks


ZÜBARİOĞLU A. U., YILDIRIM Ö., ZEYBEK C., BALABAN İ., ALİYEV B., YAZICIOĞLU V., ...Daha Fazla

Turkish archives of pediatrics (Online), cilt.56, sa.4, ss.300-307, 2021 (ESCI) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 56 Sayı: 4
  • Basım Tarihi: 2021
  • Doi Numarası: 10.5152/turkarchpediatr.2021.21010
  • Dergi Adı: Turkish archives of pediatrics (Online)
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.300-307
  • İstanbul Yeni Yüzyıl Üniversitesi Adresli: Evet

Özet

Objective: The aim of our study is to determine the relationship between exposure to hemodynamicallysignificant patent ductus arteriosus and morbidities in premature babies, the optimalnumber of pharmacologic treatment cycles, and ideal ductus ligation timing.Materials and Methods: The study was a retrospective single-center study conducted in a3-year period between July 2017 and June 2020. Premature babies, born ≤30 weeks of gestationand transferred to our unit for bedside ductus ligation, were included in the study. The subjectswere divided into 2 groups; Group A consisted of the patients who received ≥3 pharmacologictreatment cycles, and group B consisted of the patients who received ≤2 cycles. The groupswere compared according to preoperative and postoperative features. The main outcome ofthe study was the presence of severe bronchopulmonary dysplasia. The secondary outcomeswere specified as the length of stay in the neonatal intensive care unit and the duration of invasivemechanical ventilation (MV).Results: The study group consisted of 24 patients. There were 10 patients in group A and14 patients in group B. The mean gestational week and the mean birthweight were found tobe 26,7 ± 2.2 weeks and 928 ± 190 g, respectively. The incidence of severe bronchopulmonarydysplasia was significantly higher in group A (70% vs. 14.3%; P = .019). Post-ligation invasiveMV, duration, and length of stay in the intensive care unit were found to be significantly longerin group A. None of the patients had hemodynamic disturbances or complications during andafter the operation.Conclusions: Bedside surgical ductus ligation is a safe procedure. Prolonging pharmacologictreatment in order to avoid surgery increases the risk of severe bronchopulmonary dysplasiaand prolongs hospital stay.