G380 Timing of patent ductus arteriosus ligation and effects on neonatal clinical outcomes: an international comparison

Abstract

Aims Patent ductus arteriosus (PDA) is common among very preterm infants. If pharmacological closure is ineffective or contraindicated, surgical ligation may be required. Access to cardiothoracic surgery may influence the timing of ligation. We aimed to assess the impact of PDA ligation timing on neonatal clinical outcomes in two tertiary Neonatal Intensive Care Units with different surgical management of PDA: early bedside surgery vs. referral to a cardiac surgery centre. Methods In-born infants in a University Hospital in Bologna, Italy (group 1, bedside ligation) and a UK tertiary University Hospital (group 2, referred to cardiac surgical centres) who underwent PDA ligation between 2006 and 2016 were included in this retrospective cohort study if fulfilling the following criteria: gestational age (GA) Results Thirty-four neonates were included in each group. While the delivery mode and antenatal steroids differed significantly between the study groups, no difference in GA, BW, Apgar5, sex, twinhood, and intrauterine growth restriction was observed. Group 1 underwent PDA ligation significantly earlier than group 2 (median age 12 v 39 days, p Conclusions Bedside ligation allowed an earlier surgical PDA closure and was not associated with increased mortality or surgical complication rates. Earlier PDA ligation may reduce the prevalence of oxygen need at discharge, with potential cost-benefit implications; however, further studies are needed to confirm this finding.