Preoperative predictors of worsened respiratory status after patent ductus arteriosus ligation in preterm infants

초록

Background: Preterm infants with hemodynamically significant patent ductus arteriosus (PDA) may require surgical ligation. Following the surgery, some infants may encounter a deterioration in respiratory status. This study aimed to evaluate the risk factors that can predict worsened respiratory outcomes after PDA surgical ligation. Methods: A retrospective cohort study was performed on 57 preterm infants born at less than 32 weeks of gestational age and in whom the PDA was surgically ligated between January 2014 and December 2018 at Seoul National University Children's Hospital. Participants were divided into two groups: infants with worsened respiratory outcomes 14 days after ligation and control. Worsened respiratory outcome was defined as an increase in respiratory severity score (RSS) by 30% or more at 14 days after ligation compared to RSS before ligation, or death at 14 days after ligation. Results: Among the 57 PDA-ligated infants, 12 had worsened respiratory outcomes and 45 did not. The worsened respiratory outcomes were associated with oligohydramnios (adjusted OR 1.38, 95% CI 1.1-1.73, p < 0.01) and lower weight at surgery (adjusted OR 0.99, 95% CI 0.99-0.99, p = 0.02), compared to the control. Conclusion: Worsened respiratory outcomes after PDA ligation appeared to be associated with oligohydramnios, and lower weight on the day of surgery.

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