Persistencia del conducto arterioso en el recién nacido pretérmino: experiencia en una unidad neonatal de referencia de nivel IIIB

Background and objectives: Patent ductus arteriosus (PDA) is a prevalent condition in preterm infants that may be related to increased morbidity and mortality. Current trend is a conservative management. The aim of the study was to describe our experience in a IIIB level neonatal unit in relation to the epidemiology, management and morbi-mortality associated with PDA. Patients and methods: A retrospective observational and analitical study was conducted on preterm infants less than 32 weeks of gestation or weight less than 1500 grams, in which echocardiogram was performed. Results: Of 117 patients enrolled, 75.2% had PDA, of which 87.5% were hemodynamically significant (HS-PDA). All of them, but one, received medical treatment. Surgical closure was performed in 17.2% of PDA. Patients with HS-PDA presented higher incidence of moderate-severe bronchopulmonary dysplasia (BPD) (p <0.001), necrotizing enterocolitis (p <0.001) or retinopathy (p <0.001). No differences were found between the incidence of moderate-severe BPD and ductal closure after treatment (p = 0.473). Patients with HS-PDA were discharged with higher postmenstrual age (p = 0.003), also without differences with ductal closure (p = 0.186). Conclusions:HS-PDA is associated with higher incidence of moderate-severe BPD, necrotizing enterocolitis or retinopathy, and longer duration of hospital stay. Ductus closure with medical or surgical treatment has not been shown to decrease the incidence of BPD or the length of hospital stay.Antecedentes y objetivos: El ductus arterioso persistente (DAP) es una patología prevalente en el recién nacido pretérmino (RNPT) que puede relacionarse con mayor morbimortalidad, siendo la tendencia actual el manejo conservador. El objetivo es describir nuestra expeciencia en una unidad neonatal de nivel IIIB, en relación a la epidemiología, manejo y morbi-mortalidad asociada al DAP. Material y métodos: Estudio retrospectivo observacional analítico, que incluyó RNPT menores de 32 semanas de gestación o 1.500 g, con estudio ecocardiográfico. Resultados: De 117 pacientes, 75,2% presentó DAP, el 87,5% de los cuales fue hemodinámicamente significativo (DAP-HS). Todos, salvo uno, recibieron tratamiento médico. 17,2% de los DAP precisó cierre quirúrgico. Los pacientes con DAP-HS presentaron más displasia broncopulmonar (DBP) moderada-grave (p<0,001), enterocolitis necrotizante (p<0,001) y retinopatía (p