Restrictive Threshold for the Management of Patent Ductus Arteriosus in Very Low Birth Weight Neonates.

OBJECTIVE To compare outcomes of very low birth weight (VLBW) neonates before and after the change in practice for treatment of PDA. METHODS Medical records of VLBW neonates were reviewed. Neonates were categorized in two groups: Period I (January, 2012 to July, 2015) and Period II (August, 2015 to December, 2016). The primary outcome of study was composite outcome of death or broncho-pulmonary dysplasia (BPD). RESULTS The composite outcome (Death/BPD) was comparable in two groups; adjusted OR (95% CI) 1.1 (0.6, 1.9). Mortality and severe BPD were also comparable. The pharmacological treatment for PDA was required in 8.4% vs 2.6% of VLBW neonates during Period I and II, respectively (P=0.03). Durations of invasive and noninvasive ventilation were comparable during two periods. CONCLUSIONS Restrictive threshold for management of PDA in VLBW neonates may not be associated with increase in morbidities or mortality and possibly would reduce need for pharmacological treatment or surgical ligation.