Problemática da persistência do canal arterial: um vilão ou uma alteração presente ao acaso?

Abstract

OBJECTIVE: To analyze newborns weighing less than 1500g at birth who developed complications like bronchopulmonary dysplasia, retinopathy of prematurity, peri-intraventricular hemorrhage, pulmo-nary hemorrhage and necrotizing enterocolitis with or without patent ductus arteriosus (PDA). The aim was to establish a causal relationship between them. METHOD: Search in the database of the Bra-zilian Network of Neonatal Research of newborns from the Hilda Brandão Maternity Hospital at Santa Casa de Belo Horizonte - MG, between 2014-2019. It included babies who were born or were admitted to the maternity ward with birth weight between 401 and 1500g or gestational age of 22 weeks and 0 days to 29 weeks and 6 days. RESULTS: It was observed that for all complications, the absolute num-ber of cases was considerably higher in the presence of PDA. However, in our sample, after the statis-tical analises, there was no causal relationship between the events studied (patent ductus arteriosus X complications). CONCLUSION: The presence of some association between patent ductus arteriosus and diseases and complications inherent to prematurity is indisputable. However, as suggested in other case series, in this study, a causal relationship between PDA and the studied comorbidities was not established. It suggests that maybe all the conditions (including the patency of the canal) are just mo-re common in a group of severe preterm infants. The absence of a causal association leads us to re-flect on the PDA closure treatment, opting for less interventionist and more selective approaches.