8-PDA治疗还是不治疗(Sekar)-(庄改改)-完成.pptVIP

* 对于那些在一个封闭的导管氧气和更少的MV少 * Cooke L, Steer P, Woodgate P. Indomethacin for asymptomatic patent ductus arteriosus in preterm infants. Cochrane Database of Systematic Reviews 2003, Issue 1. Art. No.: CD003745. * Three intravenous doses of either indomethacin (0.2 mg/kg, at 12-hour intervals) or ibuprofen (a first 10 mg/kg dose followed by 2 doses of 5 mg/kg at 24-hour intervals) were given. The medication was infused continuously over a period of 15 minutes. Cumulative closure rate after 3 standard doses was 73% for ibuprofen-treated infants and 69% for those receiving indomethacin A total of 25 patients in each group received 3 further rescue doses, achieving closure in 12/25 (48%) in the ibuprofen group and 11/25 (44%) in the indomethacin group—for a total efficacy of 86% and 82%, respectively In 2 of the patients, minimal ductal shunting after medical therapy was observed, and the patients did not require respiratory support, therefore, no further treatment was attempted. The ductus was considered to have closed spontaneously in these cases. Lago echocardiographically studied the first 50 patients in both groups after each dose of the drug to ascertain the rate of PDA closure. All patients underwent echocardiographic and Doppler evaluation after the last dose of the assigned treatment and subsequently after a second non-randomised rescue treatment, if necessary, or whenever there was clinical suspicion that the ductus had reopened after closure There have been no well-controlled randomized clinical trials comparing NeoProfen to Indocin over multiple courses of therapy. No safety and efficacy claims may be made based on this data. Reference: Lago P, Bettiol T, Salvadori S, et al. Safety and efficacy of ibuprofen versus indomethacin in preterm infants treated for patent ductus arteriosus: a randomized controlled trial. Eur J Pediatr. 2002; 161:202-207. * Adapted from Clyman RI, Chorne N. Patent ductus arteriosus: evidence for and against treatment. J Pediat