The study of platelet parameters within the first week of life to predict drug intervention failure of patent ductus arteriosus in preterm infants

Abstract

Objective To study the value of platelet parameters within the first week of life in predicting drug intervention failure of haemodynamically significant patent ductus arteriosus (hsPDA) in preterm infants. Method The preterm infants admitted to NICU of the Affiliated Xuzhou Hospital to the Southeast University from Nov 2010 to Jul 2016 were studied. All preterm infants with hsPDA were treated with ibuprofen or acetaminophen, and were assigned into the success group and the failure group. The following data were retrospectively collected: platelet parameters included platelet counts, plateletocrit, platelet distribution width, mean platelet volume, and platelet-large cell ratio in blood cell analysis of venous blood in the first 24 hours and the 4~7 days of life. Echocardiography was done 72 hours after the usage of ibuprofen or acetaminophen treatment. Result There were 107 preterm infants with hsPDA in our study, 76 infants in the success group and 31 infants in the failure group. Among the platelet parameters in the first 24 hours and the 4~7 days of life, there were significant difference only in the plateletocrit in the 4~7 days after birth between the success group and the failure group (0.21%±0.13% vs. 0.15%±0.07%, P=0.024). The smaller birth weight, the respiratory distress syndrome, and the smaller plateletocrit in the 4~7 days of life were the independent risk factors for the drug intervention failure of hsPDA in preterm infants. The area under the receiver operating characteristic curves of the plateletocrit in the 4~7 days of life for predicting the drug intervention failure of hsPDA in preterm infants was 0.630 (95%CI 0.502~0.757, P=0.036). The best prediction cutoff value of the plateletocrit in the 4~7 days of life was 0.125% (sensitivity was 35.5%, specificity was 92.1%). Conclusion The smaller birth weight, with respiratory distress syndrome, and the smaller plateletocrit in the 4~7 days of life were the independent risk factors of the drug intervention failure of hsPDA in preterm infants. The value of the plateletocrit in the 4~7 days of life in predicting the drug intervention failure of hsPDA in preterm infants was lower. Key words: Blood platelets; Ductus arteriosus, patent; Infant, premature; Treatment failure