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 machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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 source (direct Gemma or distilled Codex), 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".