Hemodynamic and clinical consequences of early versus delayed closure of patent ductus arteriosus in extremely low birth weight infants

Objectives To describe changes in hemodynamics, respiratory support, and growth associated with transcatheter PDA closure (TCPC) in ELBW infants, stratified by postnatal age at treatment. Study design This is an observational study of ELBW infants who underwent TCPC at ≤4 weeks (Group-1; n = 34), 4–8 weeks (Group-2; n = 33), and >8 weeks of age (Group-3; n = 33). Hemodynamic assessment was performed during TCPC. Multivariate Cox-proportionate-hazard modeling was used to identify factors associated with respiratory severity score (RSS) > 2 for >30 days following TCPC. Results In comparison with Group-1, Group-3 infants had higher pulmonary vascular resistance (PVRi = 3.3 vs. 1.6 WU * m 2 ; P = 0.01), less weight gain between 4 and 8 weeks of age (16 vs. 25 g/day) and took longer to achieve RSS 2 for >30 days was associated with TCPC > 8 weeks (OR = 3.2, 95% CI: 1.75–5.8; p = 0.03) and PVRi ≥ 3 (OR = 4.5, 95% CI: 2.7–8.9; p