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Chest shielding for prevention of a haemodynamically symptomatic patent ductus arteriosus in preterm infants receiving phototherapy

  • Protocol
  • Intervention

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Abstract

This is the protocol for a review and there is no abstract. The objectives are as follows:

The primary objective will be to determine if chest shielding of preterm infants receiving phototherapy versus sham shielding or no shielding reduces the incidence of symptomatic and/or haemodynamically significant patent ductus arteriosus (PDA), and reduces subsequent morbidity secondary to a PDA and mortality.

The secondary objectives will be to determine whether chest shielding of preterm infants receiving phototherapy versus sham shielding or no shielding reduces the incidence of symptomatic and/or haemodynamically significant PDA and reduces subsequent morbidity secondary to a PDA and mortality, based on to the following subgroups.

  1. Ductus arteriosus (DA) status at enrolment: given prophylactically (all infants); infants with a symptomatic and/or haemodynamically significant DA; or infants with an asymptomatic PDA.

  2. Gestational age (< 28 weeks, 28 to 32 weeks, and 33 to 37 weeks).

  3. Timing of initiation of chest shielding (early: one to three days; intermediate: four to seven days; and late: > 7 days).

  4. Intensity of phototherapy (4 цW/cm2 to 10 цW/cm2, 10 цW/cm2 to 20 цW/cm2, and > 20 цW/cm2).

  5. Wavelength of phototherapy (430 nm to 460 nm and 460 nm to 490 nm).

  6. Type of phototherapy (fluorescent, light emitting diode, and fibreoptic).

  7. Site of phototherapy (chest, back, and chest and back).

  8. Area of chest shielding (5%, 10%, and 20% of body surface area).

We will undertake separate comparisons of trials that enrolled the following infants:

  1. unselected infants (not enrolled on the basis of a PDA detected clinically or echocardiographically); and

  2. infants with a PDA (enrolled with clinical or echocardiographic signs of a PDA).

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