Patent ductus arteriosus (PDA) and response to late surfactant treatment in premature infants

Objective To determine the clinical/echocardiography (ECHO) phenotype of patients with hypoxic respiratory failure (HRF) and response to late surfactant, according to patent ductus arteriosus (PDA) status. Study design This retrospective study included infants ≤26 +6 weeks gestation who received ≥1...

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Bibliographic Details
Published in:Journal of perinatology 2023-10, Vol.43 (10), p.1245-1251
Main Authors: Beauchene, Madeline S., Cunningham, Alison M., Stanford, Amy H., Bischoff, Adrianne R., Dagle, John M., Rios, Danielle R., Klein, Jonathan M., Giesinger, Regan E., McNamara, Patrick J.
Format: Article
Language:English
Subjects:
631/443/592/75/593
692/699/75
Cardiovascular disease
Clinical outcomes
Clinical trials
Congenital diseases
Coronary vessels
Echocardiography
Gestation
Hypoxia
Infants
Medicine
Medicine & Public Health
Neonates
Patients
Pediatric Surgery
Pediatrics
Phenotypes
Premature babies
Premature birth
Surfactants
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Summary:Objective To determine the clinical/echocardiography (ECHO) phenotype of patients with hypoxic respiratory failure (HRF) and response to late surfactant, according to patent ductus arteriosus (PDA) status. Study design This retrospective study included infants ≤26 +6 weeks gestation who received ≥1 surfactant dose after 6 postnatal days and where PDA status was available by ECHO. Response to surfactant was appraised based on change in respiratory severity score over 48 h. The relationship between PDA status and response to surfactant was evaluated via univariate analysis. Result We studied late surfactant ( n  = 71 doses) administration in 35 preterm infants born at a mean weight and GA at birth were 595 g (508, 696) and 23.3 (22.7, 25) weeks, respectively of whom 16 (46%) had a diagnosis of PDA. Positive response to late surfactant treatment was independently associated with absence of PDA [OR 26 (2, 334), p  = 0.01] whereas presence of PDA was independently associated with negative response [OR 12 (1.1, 126), p  = 0.04]. Conclusions In neonates ≤26 +6 weeks gestation, with HRF, response to surfactant after postnatal day 6 is influenced by PDA status. Future trials should consider PDA status which may enhance diagnostic precision and refine patient selection for late surfactant treatment.
ISSN:0743-8346
1476-5543
DOI:10.1038/s41372-023-01689-2