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Influence of Phototherapy on Incidence of Patent Ductus Arteriosus in Very Low Birth W eight Infants

Journal of the Korean Pediatric Society 1997;40(10):1410-1418.
Published online October 15, 1997.
Influence of Phototherapy on Incidence of Patent Ductus Arteriosus in Very Low Birth W eight Infants
Hee Seok Kim1, Ee Kyung Kim1, Yun Kyoung Lee1, Hee Eun Lee1, Chan Hwu Park1, Kyung Ran Park1, Jun Dong Park1, Beyong Il Kim1, Woong Heum Kim1, Jung-Hwan Choi1, Yong Su Yun1, Chong Ku Yun1, Jeong Mi Lee2
1Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
2Department of pediatrics, So Hwa Children`s Hospital, Seoul, Korea
극소저출생체중아에서 황달에 대한 광선요법시 흉부 차광이 동맥관 개존증의 발병에 미치는 영향
김희석1, 김이경1, 이윤경1, 이희은1, 박찬후1, 박경란1, 박준동1, 김병일1, 김웅흠1, 최중환1, 윤용수1, 윤종구1, 이정미2
1서울대학교 의과대학 소아과학교실
2소화아동병원 소아과
Abstract
Purpose
: Patent ductus arteriosus(PDA) is a common disease in very low birth weight infants(VLBWI). Hemodynamically significant PDA increases the morbidity and mortality of premature infants. Based on experimental model, light inhibits the constriction of immature piglet' s ductal rings. No specific mechanism adequately explains the effect of light on the relaxation of PDA. Several hypotheses, including activation of photosensitive metabolites, alterations in receptors, or alterations in prostaglandin metabolism, have been postulated. The purpose of this study was to evaluate the influence of phototherapy on incidence of PDA in VLBWI. Mehtods : Sixty-three infants with birth weights less than 1,500 gm from March 1994 to February 1996 who were admitted in NICU of Seoul National University Children' s Hospital were included. Thirty-four infants from March 1995 to February 1996 were shielded with aluminium foils on left chest during phototherapy(Shield group) and twenty-nine infants from March 1994 to February 1995 were not shielded(No shield group : control group). We investigated the incidence and the perinatal risk factors of PDA.
Results
: 1) The incidence of PDA was 18% in shield group and 41% in control group. There was statistically significant between the two groups(P < 0.05). 2) There was not statistically significant between two groups with gestational age, birth weight, sex, delivery mode, etc. 3) The perinatal risk factors which were statistically significant were group and presence of respiratory distress syndrome(RDS), and use of artificial surfactant. With linear logistic regression analysis, only group(OR=8.3, 95% CI=1.17-58.69) and presence of RDS(OR=21.3, 95% CI=1.39-329.81) were proved to be related to the occurrence of PDA.
Conclusions
: We conclude that chest shielding during phototherapy is a simple and inexpensive method to decrease the incidence of PDA.
Key Words: PDA, Very low birth weight infants (VLBWI), Phototherapy, Chest shield


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