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Base excess and hematocrit predict response to indomethacin in very low birth weight infants with patent ductus arteriosus.


ABSTRACT:

Background

The treatment of patent ductus arteriosus (PDA) in very low birth weight (VLBW) infants remains a challenge. The ability to predict which infants will respond to indomethacin could spare some from the risks of unnecessary medications. Our objective was to determine if indicators of acid-base homeostasis could predict response to indomethacin treatment for ductal closure, and thus help guide treatment decisions.

Methods

We performed a retrospective analysis of medical records of VLBW (ResultsOf the 91 infants included in the study, 62 (68%) responded to the first course of indomethacin with successful ductal closure. Multivariable regression modeling revealed that both base excess and hematocrit were independently associated with indomethacin response; odds of PDA closure increased with increasing base excess (OR [odds ratio]: 1.81; 95% confidence interval [CI]: 1.36-2.60) and increasing hematocrit (OR: 1.21; 95% CI: 1.01-1.45). The optimal cutoff value for base excess was -?4.56, with a sensitivity of 96.8% (95% CI: 89-100) and specificity of 79.3% (95% CI: 60-92); optimal cutoff value for hematocrit was 40, with 69.4% sensitivity (95% CI: 56-80) and 65.5% specificity (95% CI: 46-82).

Conclusions

Base excess and hematocrit may be independent predictors of indomethacin response in VLBW infants with PDA. Low-cost and readily accessible, acid-base indicators such as base excess could help guide treatment decisions.

SUBMITTER: Mydam J 

PROVIDER: S-EPMC6704716 | biostudies-literature | 2019 Aug

REPOSITORIES: biostudies-literature

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Publications

Base excess and hematocrit predict response to indomethacin in very low birth weight infants with patent ductus arteriosus.

Mydam Janardhan J   Rastogi Alok A   Naheed Zahra J ZJ  

Italian journal of pediatrics 20190822 1


<h4>Background</h4>The treatment of patent ductus arteriosus (PDA) in very low birth weight (VLBW) infants remains a challenge. The ability to predict which infants will respond to indomethacin could spare some from the risks of unnecessary medications. Our objective was to determine if indicators of acid-base homeostasis could predict response to indomethacin treatment for ductal closure, and thus help guide treatment decisions.<h4>Methods</h4>We performed a retrospective analysis of medical re  ...[more]

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