Pharmacologic Management of Patent Ductus Arteriosus in the Neonatal Intensive Care Unit: A Retrospective Study
Bibliographic record
Abstract
OBJECTIVE: Patent ductus arteriosus (PDA) is common in premature neonates. The use and selection of pharmacologic therapy are controversial because of unclear long-term benefits and the potential of adverse effects. The objective of this review was to explore the safety and efficacy for indomethacin, ibuprofen, and acetaminophen for PDA management. METHODS: A chart review was conducted for neonates who received pharmacologic treatment for PDA at our institution between July 1, 2016, and May 30, 2023. Data collected included treatment success or failure; adverse reactions to the medications, including renal dysfunction, gastrointestinal perforation or bleeding, hepatotoxicity, and/or death; and complications, including bronchopulmonary dysplasia, pulmonary hypertension, surgical closure, and death before discharge. RESULTS: A total of 91 neonates met the inclusion criteria. The efficacy rates for the first treatment course were 25 of 31 (80.6%) for indomethacin, 4 of 16 (25%) for ibuprofen, and 27 of 44 (61.4%) for acetaminophen. Complications occurred in 12 of 31 (38.7%) for indomethacin, 9 of 16 (56.3%) for ibuprofen, and 0 of 44 (0%) for acetaminophen. CONCLUSION: Indomethacin and acetaminophen had good efficacy, though indomethacin had a high incidence of complications. Ibuprofen had lower efficacy than expected (25%) and concerning safety outcomes, which requires further investigation to see if ethnicity plays a role.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".