Management strategies of patent ductus arteriosus in preterm chosen by neonatologists in neonatal intensive care units in Lima diring 2012

Abstract

Objective: Describe the management strategies chosen for patent ductus arteriosus in premature newborns by neonatologists in Neonatal Intensive Care Units of Lima.

Materials and methods: A cross-sectional observational study. An anonymous individual quiz applied between neonatologists practicing in Intensive Care Units of Lima.

Results: We considered 11 Neonatal Intensive Care Units comprised by 166 neonatologists (92.7% of surveyed). Neonatology residents imply the 10.24% of the total population of respondents. The 56.02% answered that had a protocol in its operational unit. About the management strategy used in newborns ≤ 28 weeks of age and weighing ≤ 1000g, a 53.61% chose ultrasound- guided strategy. The management strategy used in newborns ≥ 29 weeks of age and weighing> 1000g,the51.81%optedforultrasound-guided. 55.42% of respondents chose oral ibuprofen as first medication choice, while 43.37% selected intravenous indomethacin. The 68.67% considered derive to surgery after missing on 2nd course of treatment. The more influential external factors in the management strategy to use are the echocardiography accessibility (67.47%) and the availability of the drug (65.66%).

Conclusions: The management decision will depend on the individual experience of each neonatologist and the limitations of the institution. In both of the scenarios presented, newborns ≤ 28 weeks and / or weighing ≤ 1000g., such as newborns ≥ 29 weeks and / or weighing> 1000g., the chosen strategy is guided by echocardiography. The standard drug shortages and different schemes have determined the variety in the management reflecting the lack of consensus. The most limiting factors in ICUs in Lima are drug availability and access to echocardiography.