The Experts below are selected from a list of 31284 Experts worldwide ranked by ideXlab platform
Frank Van Bel - One of the best experts on this subject based on the ideXlab platform.
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impact of Patent Ductus Arteriosus and subsequent therapy with indomethacin on cerebral oxygenation in preterm infants
Pediatrics, 2008Co-Authors: Petra M A Lemmers, Mona C Toet, Frank Van BelAbstract:OBJECTIVES. A hemodynamically important Patent Ductus Arteriosus is a common problem in the first week of life in the preterm infant. Although Patent Ductus Arteriosus induces alterations in organ perfusion, scarce information is available of the impact of Patent Ductus Arteriosus and its subsequent treatment on the oxygen supply and oxygen extraction of the brain. We investigated the impact of Patent Ductus Arteriosus and its treatment with indomethacin on regional cerebral oxygen saturation and fractional tissue oxygen extraction by using near-infrared spectroscopy. PATIENTS AND METHODS. Twenty infants with Patent Ductus Arteriosus (gestational age: RESULTS. Mean arterial blood pressure and regional cerebral oxygen saturation were significantly lower and fractional tissue oxygen extraction significantly higher compared with the control infants during Patent Ductus Arteriosus (mean arterial blood pressure: 33 +/- 5 vs 38 +/- 6 mm Hg; regional cerebral oxygen saturation: 62% +/- 9% vs 72% +/- 10%; fractional tissue oxygen extraction: 0.34 +/- 0.1 vs 0.25 +/- 0.1, respectively). Regional cerebral oxygen saturation and fractional tissue oxygen extraction were lower and higher, respectively, up to 24 hours after the start of indomethacin but normalized to control values afterward. Indomethacin had no additional negative effect on cerebral oxygenation. CONCLUSIONS. A hemodynamically significant Patent Ductus Arteriosus has a negative effect on cerebral oxygenation in the premature infant. Subsequent and adequate treatment of a Patent Ductus Arteriosus may prevent diminished cerebral perfusion and subsequent decreased oxygen delivery, which reduces the change of damage to the vulnerable immature brain.
Ivan D Frantz - One of the best experts on this subject based on the ideXlab platform.
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Patent Ductus Arteriosus therapy impact on neonatal and 18 month outcome
Pediatrics, 2009Co-Authors: Juliette Madan, Douglas E Kendrick, James I Hagadorn, Ivan D FrantzAbstract:OBJECTIVE. The purpose of this work was to evaluate therapy for Patent Ductus Arteriosus as a risk factor for death or neurodevelopmental impairment at 18 to 22 months, bronchopulmonary dysplasia, or necrotizing enterocolitis in extremely low birth weight infants. METHODS. We studied infants in the National Institute of Child Health and Human Development Neonatal Research Network Generic Data Base born between 2000 and 2004 at 23 to 28 weeks9 gestation and at RESULTS. Treatment for subjects with Patent Ductus Arteriosus (n = 2838) included 403 receiving supportive treatment only, 1525 treated with indomethacin only, 775 with indomethacin followed by secondary surgical closure, and 135 treated with primary surgery. Patients who received supportive therapy for Patent Ductus Arteriosus did not differ from subjects treated with indomethacin only for any of the outcomes of interest. Compared with indomethacin treatment only, patients undergoing primary or secondary surgery were smaller and more premature. When compared with indomethacin alone, primary surgery was associated with increased adjusted odds for neurodevelopmental impairment and bronchopulmonary dysplasia in multivariable logistic regression. Secondary surgical closure was associated with increased odds for neurodevelopmental impairment and increased adjusted odds for bronchopulmonary dysplasia but decreased adjusted odds for death. Risk of necrotizing enterocolitis did not differ among treatments. Indomethacin prophylaxis did not significantly modify these results. CONCLUSIONS. Our results suggest that infants treated with primary or secondary surgery for Patent Ductus Arteriosus may be at increased risk for poor short- and long-term outcomes compared with those treated with indomethacin. Prophylaxis with indomethacin in the first 24 hours of life did not modify the subsequent outcomes of Patent Ductus Arteriosus therapy.
Petra M A Lemmers - One of the best experts on this subject based on the ideXlab platform.
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impact of Patent Ductus Arteriosus and subsequent therapy with indomethacin on cerebral oxygenation in preterm infants
Pediatrics, 2008Co-Authors: Petra M A Lemmers, Mona C Toet, Frank Van BelAbstract:OBJECTIVES. A hemodynamically important Patent Ductus Arteriosus is a common problem in the first week of life in the preterm infant. Although Patent Ductus Arteriosus induces alterations in organ perfusion, scarce information is available of the impact of Patent Ductus Arteriosus and its subsequent treatment on the oxygen supply and oxygen extraction of the brain. We investigated the impact of Patent Ductus Arteriosus and its treatment with indomethacin on regional cerebral oxygen saturation and fractional tissue oxygen extraction by using near-infrared spectroscopy. PATIENTS AND METHODS. Twenty infants with Patent Ductus Arteriosus (gestational age: RESULTS. Mean arterial blood pressure and regional cerebral oxygen saturation were significantly lower and fractional tissue oxygen extraction significantly higher compared with the control infants during Patent Ductus Arteriosus (mean arterial blood pressure: 33 +/- 5 vs 38 +/- 6 mm Hg; regional cerebral oxygen saturation: 62% +/- 9% vs 72% +/- 10%; fractional tissue oxygen extraction: 0.34 +/- 0.1 vs 0.25 +/- 0.1, respectively). Regional cerebral oxygen saturation and fractional tissue oxygen extraction were lower and higher, respectively, up to 24 hours after the start of indomethacin but normalized to control values afterward. Indomethacin had no additional negative effect on cerebral oxygenation. CONCLUSIONS. A hemodynamically significant Patent Ductus Arteriosus has a negative effect on cerebral oxygenation in the premature infant. Subsequent and adequate treatment of a Patent Ductus Arteriosus may prevent diminished cerebral perfusion and subsequent decreased oxygen delivery, which reduces the change of damage to the vulnerable immature brain.
Juliette Madan - One of the best experts on this subject based on the ideXlab platform.
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Patent Ductus Arteriosus therapy impact on neonatal and 18 month outcome
Pediatrics, 2009Co-Authors: Juliette Madan, Douglas E Kendrick, James I Hagadorn, Ivan D FrantzAbstract:OBJECTIVE. The purpose of this work was to evaluate therapy for Patent Ductus Arteriosus as a risk factor for death or neurodevelopmental impairment at 18 to 22 months, bronchopulmonary dysplasia, or necrotizing enterocolitis in extremely low birth weight infants. METHODS. We studied infants in the National Institute of Child Health and Human Development Neonatal Research Network Generic Data Base born between 2000 and 2004 at 23 to 28 weeks9 gestation and at RESULTS. Treatment for subjects with Patent Ductus Arteriosus (n = 2838) included 403 receiving supportive treatment only, 1525 treated with indomethacin only, 775 with indomethacin followed by secondary surgical closure, and 135 treated with primary surgery. Patients who received supportive therapy for Patent Ductus Arteriosus did not differ from subjects treated with indomethacin only for any of the outcomes of interest. Compared with indomethacin treatment only, patients undergoing primary or secondary surgery were smaller and more premature. When compared with indomethacin alone, primary surgery was associated with increased adjusted odds for neurodevelopmental impairment and bronchopulmonary dysplasia in multivariable logistic regression. Secondary surgical closure was associated with increased odds for neurodevelopmental impairment and increased adjusted odds for bronchopulmonary dysplasia but decreased adjusted odds for death. Risk of necrotizing enterocolitis did not differ among treatments. Indomethacin prophylaxis did not significantly modify these results. CONCLUSIONS. Our results suggest that infants treated with primary or secondary surgery for Patent Ductus Arteriosus may be at increased risk for poor short- and long-term outcomes compared with those treated with indomethacin. Prophylaxis with indomethacin in the first 24 hours of life did not modify the subsequent outcomes of Patent Ductus Arteriosus therapy.
François Laborde - One of the best experts on this subject based on the ideXlab platform.
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Videothoracoscopic Closure of Patent Ductus Arteriosus
Minimally Invasive Thoracic and Cardiac Surgery, 2012Co-Authors: Thierry Folliguet, François LabordeAbstract:A videothoracoscopic surgical technique for closure of Patent Ductus Arteriosus in children is described. Only three ports access are necessary to dissect the Patent Ductus Arteriosus from the surrounding tissues and to apply the two titanium clips. The advantages given are its low morbidity, lack of mortality, and reliable closure. We believe that the videothoracoscopic surgical approach is the technique of choice for Patent Ductus Arteriosus closure in children.
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Closure of Patent Ductus Arteriosus
Endoscopic Surgery in Children, 1999Co-Authors: François Laborde, Thierry FolliguetAbstract:Pediatric video-assisted thoracic surgery (VATS) applications have been limited by a lack of equipment and techniques adapted to small infants. However, recently the introduction of a small video-camera has allowed the development of surgical operations in children. Pediatric VATS was initially reported for Patent Ductus Arteriosus (PDA), followed by vascular ring divison, collateral interruption (arterial and venous), pericardial drainage, thoracic Ductus interruption and diagnostic VATS (location of aberrant coronary artery) [1–4]. We started performing VATS in the pediatric population for Patent Ductus Arteriosus closure in 1991, and since then we have performed over 300 cases.
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Videothoracoscopic Surgical Interruption of Patent Ductus Arteriosus
The Annals of Thoracic Surgery, 1997Co-Authors: Emmanuel Le Bret, Thierry Folliguet, François LabordeAbstract:A videothoracoscopic surgical technique for closure of Patent Ductus Arteriosus in children is described. Only three ports of access are necessary to dissect the Patent Ductus Arteriosus from the surrounding tissues and to apply the two titanium clips. The advantages given are the technique's low morbidity, lack of mortality, and reliable closure. We believe that the videothoracoscopic surgical approach is the technique of choice for Patent Ductus Arteriosus closure in children.
