A survey on the treatment strategy of XXXX in very low-birth-weight @entity1 .

@entity1 @entity2461 @entity4053 @entity4290 @entity3352 @entity360
This study is a retrospective analysis of the clinical data of 67 very low birth weight @entity1 (VLBWI) with symptomatic @entity2461 ( @entity2461 ); all were admitted to four neonatal intensive care units (NICU) from January 1, 1996 through December 31, 1996. The mean gestational age was 27.9 +/- 2.4 weeks, the mean birth weight was 1078 +/- 193 g. Fifty-six @entity1 (83.6%) had @entity4290 , and 53 @entity1 (79%) received artificial surfactant. The NICU at a regional hospital used CVD score > or =3 as the sole criteria and the remaining three NICUs used color Doppler echocardiogram to confirm a symptomatic @entity2461 and to treat it; sometimes LA/AO > or = 1.3 was used as the criteria for @entity3352 treatment. Two of these three hospitals sometimes used the pulsed Doppler echocardiogram as well as color Doppler examination as the treatment criteria. Seven @entity1 (10.5%) had contraindication for @entity3352 treatment; four of them closed after conservative treatment, and another three were subjected to surgical ligation. Of the remaining 60 @entity1 , 3 were treated with oral @entity3352 and 57 were treated with intravenous @entity3352 . The mean age when initial treatment given was 3.8 +/- 1.5 days (range, 8 hours approximately 20 days). Among them 10 (16.7%) were within 24 hours after birth, 25 (41.7%) were between 24 and 48 hours, and 25 (41.7%) were beyond 48 hours. The dosage of @entity3352 was 0.2 mg/kg per dose intravenously every 12 to 24 hours for three doses as a full course, if not contraindicated. The mean dose of @entity3352 was 2.8 +/- 1.5; 10 @entity1 (16.7%) received 1 dose, 15 (25%) received 2 doses, 27 (45%) received 3 doses, 3 (5%) received 4 doses and 5 (8.3%) received 6 doses. Among them, 51 @entity1 (85%) @entity2461 closed (including 2 treated with oral @entity3352 ), 9 (15%) failed to close and 6 of them received surgical ligation (including 1 treated with oral @entity3352 ). The complications associated with @entity3352 treatment were @entity4053 (52%), decreased urine output (42%) and @entity360 (32%). The @entity1 with @entity4290 had an earlier mean age of initial treatment than non- @entity4290 @entity1 (3.3 +/- 2.5 vs. 7.6 +/- 5.6 days; p < 0.05), and also had a higher closure rate (89% vs. 57%; p < 0.05). There was a closure rate of 85% in this multicenter retrospective analysis. Even though the @entity1 received only one or two doses, they still had a good chance of ductal closure (21/25, 84%). To minimize the complications associated with @entity3352 treatment in VLBWI, the protocol of @entity3352 treatment should be re-evaluated.
