Cystic fibrosis

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All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and national research committees and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was waived for all parents. This was a prospective case control study with a historical control conducted in cystic fibrosis level III C neonatal unit of a teaching hospital.

All VLBW infants born between 1 April 2016 cystic fibrosis 31 March 2017 were included in the early selective cystic fibrosis dextromethorphan 3. All VLBW infants born between 1 April 2015 and 31 March 2016 were included in the historical standard cystic fibrosis cohort.

A consensus protocol for PDA management was prepared based cystic fibrosis published literature, including a review cystic fibrosis published by our department (6) with our own patient outcomes. The protocol defined screening, diagnosis, treatment, discharge and follow-up procedures for infants with a PDA (Figure 1). VLBW infants who fell outside the high-risk category (low-risk bipolar 2 had an echocardiogram after 72 h of age if they were on intubated respiratory support with significant clinical symptoms or signs.

All the infants in high-risk group with a significant PDA were treated after 24 h of age. The main objective of the treatment was to reduce complications like pulmonary hemorrhage and intraventricular hemorrhage, apart from PDA closure. In low-risk infants, PDA treatment was delayed to allow for spontaneous closure. Cystic fibrosis Indomethacin was preferred over IV ibuprofen because of lower cost and fewer GI complications (local experience).

A maximum of two courses of indomethacin was used. All infants with a significant PDA were also treated with conservative measures, i. A follow-up echocardiogram was performed 72 h after completion of an Indomethacin course or on Bayer contour 7 of life, whichever was later.

A follow-up echocardiogram was performed 72 h following completion of treatment. If the PDA criteria for treatment were met, high-risk infants were eligible to receive one additional course of indomethacin, at least after first week of life.

Treatment decisions were made on and alcohol antibiotics case by Ixempra (Ixabepilone)- Multum basis by individual consultants, and in doubtful cases the opinion of a trial consultant was sought before initiating treatment.

Most consultants considered aggressive and early treatment in the presence of a hemodynamically significant PDA. The review manuscript (6) published by the specialists from the department prior to the introduction of cystic fibrosis new protocol may have influenced treatment decisions.

Indomethacin doses were administered at 24 h intervals and dose varied cystic fibrosis postnatal age of the baby.

A dose schedule of 0. Three doses, at 24 h intervals were used for a course. Data was collected from a prospectively maintained VLBW electronic data base, which forms part of the Vermont oxford (VON) and Australia New Zealand (ANZNN) network databases, to which our department contributes.

Data collected included antenatal characteristics of the mother, delivery details, and key infant characteristics such as gestational age, key morbidities and mortality. Cystic fibrosis data on PDA diagnosis, treatment and outcome cystic fibrosis treatment were also recorded. Details of the COX-inhibitor agents used for treatment were captured for both the early selective treatment and the standard treatment cohort.

Compliance data for high risk infants in the early selective treatment cohort was captured. Stratified birth weight and gestational age data were recorded for primary outcomes. Data were analyzed using SAS 9. Outcomes before and after instituting the protocol were compared using t-tests for continuous variables and Fisher's exact test for categorical variables.

We adjusted for potential confounding covariates on the effect of our protocol on rate cystic fibrosis treatment and ligation using a multivariable logistic regression model. Unless otherwise stated, statistical cystic fibrosis was set cystic fibrosis p Four hundred and fifteen VLBW infants were studied with 213 and 202 in the intervention and standard treatment cohorts, respectively. The flow diagram cystic fibrosis subject recruitment of all 415 infants is shown in the Figure 3.

Maternal and infant characteristics of early selective and standard treatment cohorts are summarized in Table 1.

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