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IS LATE TREATMENT WITH ACETAMINOPHEN SAFE AND EFFECTIVE IN AVOIDING SURGICAL LIGATION AMONG EXTREMELY PRETERM NEONATES WITH PERSISTENT PATENT DUCTUS ARTERIOSUS?
Mashally, Sally et al. | Date Issued: 2021
Author
Mashally, Sally
Banihani, Rudaina
Jasani, Bonny
Nield, Lynne E.
Martins, Fernando F.
Jain, Amish
Weisz, Dany E.
Affilliation
Sunnybrook Health Sciences Centre. Department of Newborn and Developmental Pediatrics. Toronto, ON, Canada.
Sunnybrook Health Sciences Centre. Department of Newborn and Developmental Pediatrics. Toronto, ON, Canada / University of Toronto. Department of Pediatrics. Toronto, ON, Canada.
University of Toronto. Department of Pediatrics. Toronto, ON, Canada / Hospital for Sick Children. Division of Neonatology. Department of Pediatrics. Toronto, ON, Canada.
Sunnybrook Health Sciences Centre. Department of Newborn and Developmental Pediatrics. Toronto, ON, Canada / University of Toronto. Department of Pediatrics. Toronto, ON, Canada / Hospital for Sick Children. Division of Neonatology. Department of Pediatrics. Toronto, ON, Canada.
Fundação Oswaldo Cruz. Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira. Departamento de Neonatologia. Rio de Janeiro, RJ, Brasil.
University of Toronto. Department of Pediatrics. Toronto, ON, Canada / Mt. Sinai Hospital. Department of Pediatrics. Toronto, ON, Canada.
Sunnybrook Health Sciences Centre. Department of Newborn and Developmental Pediatrics. Toronto, ON, Canada / University of Toronto. Department of Pediatrics. Toronto, ON, Canada.
Abstract
Objective: Evaluate the association of late treatment with acetaminophen vs. immediate surgical ligation with death or neurodevelopmental impairment (NDI) among extremely low gestational age neonates (ELGANs) with persistent patent ductus arteriosus (pPDA). Study design: Retrospective comparative epoch study of ELGANs with pPDA being considered for surgical ligation. ELGANs in epoch 1 (2009-2012) were referred for ligation, while infants in epoch 2 (2012-2015) were treated with oral acetaminophen and referred for ligation in the absence of improvement. The primary outcome was a composite of death/NDI at 18-24 months. Results: Ninety-two ELGANs with median[IQR] GA 25.2 weeks [24.4, 26.3] had pPDA (43 in epoch 1, 49 in -epoch 2) with acetaminophen-exposed neonates receiving 7 days [7, 7] of treatment. ELGANs in epoch 2 had reduced ligation (aOR 0.30; 95%CI: [0.11, 0.87]), but there was no difference in death/NDI (aOR 1.03; 95%CI: [0.30, 3.56]). Conclusions: Late treatment with acetaminophen to avoid surgery for pPDA is associated with reduced ligation but no difference in death/NDI, supporting the safety and effectiveness of this approach.
Keywords
Congenital heart defects
Paediatrics
 
Publisher
Springer Nature
Citation
MASHALLY, Sally et al. Is late treatment with acetaminophen safe and effective in avoiding surgical ligation among extremely preterm neonates with persistent patent ductus arteriosus? Journal of Perinatology, p. 1-7, 27 Aug. 2021.
DOI
10.1038/s41372-021-01194-4
ISSN
0743-8346
Notes
The online version contains supplementary material available at 10.1038/s41372-021-01194-4.