Brandt Chase, Mat Hatice Dilara, Bischoff Adrianne R, McNamara Patrick J, Rios Danielle R
University of Iowa, Roy J. and Lucille A. Carver College of Medicine, Iowa City, IA, USA.
Division of Neonatology, Department of Pediatrics, University of Iowa, Iowa City, IA, USA.
J Perinatol. 2025 Sep 20. doi: 10.1038/s41372-025-02437-4.
Compare the incidence of death or adverse respiratory outcome in patients with low shunt burden from PDA to those with no PDA and evaluate secondary outcomes associated with PDA between groups.
Retrospective cohort study of all infants born <30 weeks gestation from 8/2018 to 5/2023 with TNE in the first postnatal week. Two groups: no PDA burden and low PDA burden. Primary outcome was composite of death or adverse respiratory outcome.
112 infants [no PDA (n = 69), low PDA burden (n = 43)] with mean gestational age and birth weight 27 ± 2 weeks and 1006 ± 310 g, respectively, were included. Baseline demographics were comparable with no difference in primary outcome (p = 0.2).
Prolonged exposure to low-volume PDA shunt was not associated with increased risk of death or abnormal respiratory outcome. Findings highlight the importance of redefining eligibility criteria for PDA trials, based on adjudication of shunt volume, to limit enrollment to patients with moderate- to high-volume shunts.
比较动脉导管未闭（PDA）分流负担低的患者与无PDA患者的死亡或不良呼吸结局发生率，并评估两组之间与PDA相关的次要结局。
对2018年8月至2023年5月出生孕周<30周且出生后第一周内接受经鼻持续气道正压通气（TNE）的所有婴儿进行回顾性队列研究。分为两组：无PDA负担组和低PDA负担组。主要结局是死亡或不良呼吸结局的复合指标。
纳入112例婴儿[无PDA（n = 69），低PDA负担（n = 43）]，平均孕周和出生体重分别为27±2周和1006±310 g。基线人口统计学特征具有可比性，主要结局无差异（p = 0.2）。
长时间暴露于小分流的PDA与死亡风险增加或呼吸结局异常无关。研究结果强调了根据分流体积判定重新定义PDA试验入选标准的重要性，以便将入组限制在中高分流体积的患者。
