Dear Colleague,

My name is Dr. Adam Hoellering. I am an advanced trainee in neonatology and I am working on a research programme at the Mater Mothers' Hospital, Brisbane. I would like to ask you for 5 minutes to complete the following survey. I intend to analyse the data as part of a project on PDA in pre-term infants.

Thanks & Regards,

Adam Hoellering.
 
Current management practices for PDA in pre-term infants in Australia and New Zealand
Survey

Your Email :
1. Does your unit have a written protocol for the management of PDA in pre-term infants? Yes No
2. Into which category does your management strategy best fit? (Please tick applicable answers )

    If you adopt a gestation based approach,
       ≤28 weeks ≥29 weeks  
    Expectant therapy (medical treatment when a PDA becomes clinically apparent)  
    Prophylactic therapy (administer treatment to all infants within 12h unless contraindicated)  
    Targeted presymptomatic therapy (treat dependent on ductal diameter measured using ECHO colour Doppler at 3 to 6h of life)  
    or, If you adopt a weight based approach :
      ≤1000g 1000-1499g ≥1500g
    Expectant therapy (medical treatment when a PDA becomes clinically apparent)
    Prophylactic therapy (administer treatment to all infants within 12h unless contraindicated)
    Targeted presymptomatic therapy (treat dependent on ductal diameter measured using ECHO colour Doppler at 3 to 6h of life)
 
3. Which drug do you use?

    Indomethacin  

      If indomethacin which dosing regimen do you use ?

    a) 0.1 mg/kg 24 hourly for 6 days
    b) 0.2 mg/kg 24 hourly for 3 days
    c) 0.2 mg/kg, 0.1 mg/kg, 0.1mg/kg 12 hourly intervals
    d) Other e.g. Neofax
    Ibuprofen
4. Under what circumstances do you refer for surgical ligation in an infant supported on a ventilator ?

a) Initial therapy
 b) After 1 failed course of NSAID
 c) After 2 failed courses of NSAID
 d) After 3 failed courses of NSAID
 e) Never refer
5. Under what circumstances do you refer for surgical ligation in an infant supported on a CPAP ?

a) Initial therapy
 b) After 1 failed course of NSAID
 c) After 2 failed courses of NSAID
 d) After 3 failed courses of NSAID
 e) Never refer
6. Are there any factors which you would like to elaborate on which would influence your answers to
    questions 4 and 5?
7. Has your management been influenced by recent published literature with respect to treatment of PDA ? Yes No


If yes, which if any of these publications has influenced your management?

a. Fowlie PW, Davis PG. Prophylactic intravenous indomethacin for preventing mortality and morbidity in preterm infants. Cochrane Database of Systematic Reviews 2002
 b. Cooke L, Steer P, Woodgate P. Indomethacin for asymptomatic patent ductus arteriosus in preterm infants. Cochrane Database of Systematic Reviews 2001
 c. Herrera C, Holberton J, Davis P. Prolonged versus short course of indomethacin for the treatment of patent ductus arteriosus in preterm infants. Cochrane Database of Systematic Reviews 2007
 d. Ohlsson A, Walia R, Shah S. Ibuprofen for the treatment of patent ductus arteriosus in preterm and / or low birth weight infants. Cochrane Database of Systematic Reviews 2005
 e. Schmidt B, Davis P et al Long-term effects of indomethacin prophylaxis in extremely-low-birth-weight infants. N Engl J Med 2001 ( the TIPP study)
 f. Evans, Nick. Current controversies in the diagnosis and treatment of patent ductus arteriosus in preterm infants. Adv Neonat Care 2003
 g. Kabra N, Schmidt B et al. neurosensory impairment after surgical closure of patent ductus arteriosus in extremely low birth weight infants. J Pediatrics 2007
 h. None of above

 
 Supported by Mater Research Support Centre 2007