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American Heart Association

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Final ID: Su2067

Conservative management of patent ductus arteriosus in preterm infants: a systematic review and meta-analysis of randomized controlled trials

Abstract Body (Do not enter title and authors here): Background
In recent years, there has been a rise in the adoption of conservative approaches to managing patent ductus arteriosus (PDA) in preterm infants. Systematic appraisal of the clinical evidence supporting this approach is essential for guiding recommendations in clinical guidelines.
Methods
A comprehensive search of MEDLINE (PubMed), Embase, the Cochrane Library, and ClinicalTrials.gov, spanning from inception to April 2024, was conducted to identify all relevant randomized controlled trials (RCTs) that evaluated conservative management of patent ductus arteriosus (PDA) in preterm infants. Conservative management was defined as approximately ≤25% open-label pharmacological treatment with ibuprofen, indomethacin, or paracetamol and/or ligation/endovascular closure. Our primary outcomes were the risk of all-cause mortality and bronchopulmonary dysplasia. We used RevMan 5.4 to pool risk ratios (RRs) under a random-effects model, ensuring a rigorous and reliable analysis.
Results
Our review included 6 RCTs. There was no difference in the risk of mortality (RR 0.83; 95% CI: 0.64-1.08, I2 = 0%) and BPD (RR 0.89; 95% CI: 0.76-1.03, I2 = 22%) between the conservative management and active treatment groups. The rates of necrotizing enterocolitis, intraventricular hemorrhage, retinopathy of prematurity, sepsis, pulmonary hemorrhage, and the need for surgical ligation or transcatheter occlusion were similar between the two groups.
Conclusions
The meta-analysis showed no difference in the risk of all-cause mortality, BPD, or other clinical outcomes between a strategy of conservative management compared to active treatment. These findings support a conservative approach for the management of PDA in preterm infants. Future studies should focus on cost-effectiveness analyses between the two approaches and investigate important subgroups, such as extremely preterm births.
  • Asif, Maryam  ( Alfaisal University , Riyadh , Saudi Arabia )
  • Cheema, Huzaifa Ahmad  ( King Edward Medical University , Lahore , Punjab , Pakistan )
  • Ahmad, Adeel  ( Mass General Brigham-Salem Hospital , Salem , Massachusetts , United States )
  • Rehman, Wajeeh  ( UHS , Johnson City , New York , United States )
  • Ahmed, Raheel  ( Imperial College London , London , United Kingdom )
  • Dani, Sourbha  ( Lahey Hospital and Medical Center , Burlington , Massachusetts , United States )
  • Kumar, Rajanikant  ( Jay Prabha Medanta Super Specialty Hospital , Patna , India )
  • Epia, Efeoghene Praise  ( Tbilisi State Medical University , Tbilisi , Georgia )
  • Abdelnour, Mark  ( University of California Irvine , Irvine , California , United States )
  • Kim Kim, Joo Young Belen  ( National University of Asuncion , Asuncion , Paraguay )
  • Anokye-kumatia, Anne Boakyewaa  ( Komfo Anokye Teaching Hospital , Kumasi , Ghana )
  • Kulkarni, Vrunda  ( Smt Kashibai Navale Medical College & General Hospital , Thane , India )
  • Loyi Lego, Rimmo  ( Stevens Institute of Technology , Hoboken , New Jersey , United States )
  • Ali Farhan Abbas Rizvi, Syed  ( Jinnah Sindh Medical University , Karachi , Pakistan )
  • Author Disclosures:
    Maryam Asif: DO NOT have relevant financial relationships | Huzaifa Ahmad Cheema: DO NOT have relevant financial relationships | Adeel Ahmad: DO NOT have relevant financial relationships | Wajeeh Rehman: DO NOT have relevant financial relationships | Raheel Ahmed: DO NOT have relevant financial relationships | Sourbha Dani: No Answer | Rajanikant Kumar: No Answer | Efeoghene Praise Epia: DO NOT have relevant financial relationships | Mark Abdelnour: DO NOT have relevant financial relationships | Joo Young Belen Kim Kim: DO NOT have relevant financial relationships | Anne Boakyewaa Anokye-Kumatia: DO NOT have relevant financial relationships | Vrunda Kulkarni: DO NOT have relevant financial relationships | Rimmo Loyi Lego: DO NOT have relevant financial relationships | Syed Ali Farhan Abbas Rizvi: DO NOT have relevant financial relationships
Meeting Info:

Scientific Sessions 2024

2024

Chicago, Illinois

Session Info:

ACHD and Pediatric Cardiac Surgery

Sunday, 11/17/2024 , 03:15PM - 04:15PM

Abstract Poster Session

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