Background: Recent studies have demonstrated
that platelet count (PLTc) and function have an important role in promoting spontaneous closure of the PDA in animal models.Aimto evaluate whether response to ibuprofen in premature infants with PDA is influenced by PLTc.
Methods: All infants with GA 64 28wks born in
our unit between 1/1/2007 and 31/12/2009 were
retrospectively studied. Exclusion criteria were:
congenital malformations, death within 48 hrs and outborn. All infants had echocardiographic evaluation
in 1st DoL. Patients with a hemodynamically significant
PDA (HsPDA) were treated with a standard course
of ibuprofen. GA, BW, antenatal steroids, gender,
type of ventilatory support were analyzed along with
PLTc before and after treatment. Associations with
HsPDA and treatment response were assessed by
univariate and multivariate analysis.Results: Data from 130 out of 162 newborns
(GA 26.2w\ub11.5, BW 851.2\ub1293g) were analysed.
117 patients showed a PDA at first evaluation. 88
newborns were treated with ibuprofen for HsPDA;
after treatment 60 patients had a closed ductus
(responders) while 28 were non-responders. A
lower PLTc was observed in infants with HsPDA but
difference was not statistically significant. Among
treated infants, non-responders had a lower GA,
were more likely mechanically ventilated and had
a PLT significantly lower than responders (111.000/
\u3bcl vs. 184.000/\u3bcl, p=0,001). In the multivariate
analysis only invasive ventilation and low PLTc were
independent factors for treatment failure.
Conclusion: A low PLTc increases the risk of
treatment failure of PDA. Further studies are
needed to evaluate the prognostic and therapeutic
implications of this observation