Siben pca

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14/10/08

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Página 454

SOCIEDAD IBEROAMERICANA DE NEONATOLOGÍA

SIBEN’s First Clinical Consensus:
Diagnostic and Therapeutic Approach
to the Patent Ductus Arteriosus
in Preterm Infants
S.G.Golombek*,a,b, A. Sola*,a,c, H. Baqueroa,d, D. Borboneta,e, F. Cabañasa,f,
C. Fajardoa,g, G. Goldsmita,h, L. Lemusa,i, E. Miuraa,j, A. Pellicera,f, J.M. Péreza,k,
M. Rogidoa,c, G. Zamboscoa,l and B. van Overmeirem, for the First SIBEN Clinical
Consensus Group
aSIBEN, Sociedad Iberoamericana de Neonatología. bThe Regional Neonatal Center. Maria Fareri Children’s Hospital
at WestchesterMedical Center/New York Medical College-Valhalla. Nueva York. USA. cUniversity of Medicine
and Dentistry. New Jersey. USA. dDepartamento de Neonatología. Universidad del Norte (MACSA). Baranquilla.
Colombia. eDepartamento de Neonatología. Hospital de Clínicas. Universidad de la República. Montevideo.
Uruguay. fDepartamentos de Neonatología. Hospital Universitario La Paz y Hospital Quirón. Madrid.España.
gDepartment of Pediatrics. University of Arizona. Phoenix. Arizona. USA. hArea de Terapia Intensiva Neonatal.
Hospital Nacional J.P. Garrahan. Buenos Aires. Argentina. iDepartamento de Neonatología. Hospital de Pediatría
UMAE del CMNO. Instituto Mexicano de Seguridad Social. Guadalajara. Jalisco. México. jDepartamento de
Neonatología. Hospital das Clínicas de Porto Alegre. Facultad deMedicina. Universidad Federal de Rio Grande
do Sul. Porto Alegre. RS. Brazil. kDirector Médico de PIT-UTI Neonatal. São Paulo. Brasil. lDepartamento de
Neonatología. Hospital Italiano de La Plata. Buenos Aires. Argentina. mDepartment of Paediatrics. Division
of Neonatology. University Hospital of Antwerp. Belgium.

Objective

Results

To report the process and results of the first neonatalclinical consensus of the Ibero-American region.

31 neonatologists from 16 countries agreed to participate. Presentations by each group and general discussion
were used to develop a consensus regarding: general management, availability of drugs (indomethacin vs. ibuprofen), costs, indications for echo/surgery, etc. Many steps
were learnt by all present in a collaborative forum.

Design andmethods
Two recognized experts in the field (Clyman and Van
Overmeire) and 45 neonatologists from 23 countries were
invited for active participation and collaboration. We developed 46 questions of clinical-physiological relevance in
all aspects of patent ductus arteriosus (PDA). Guidelines
for consensus process, literature search and future preparation of educational material and authorshipwere developed, reviewed and agreed by all. Participants from different countries were distributed in groups, and assigned
to interact and work together to answer 3-5 questions, reviewing all global literature and local factors. Answers and
summaries were received, collated and reviewed by 2 coordinators and the 2 experts. Participants and experts met
in Granada, Spain for 4.5 h (lectures byexperts, presentations by groups, discussion, all literature available).

Conclusions
This first consensus group of Ibero-American neonatologists SIBEN led to active and collaborative participation of
neonatologists of 16 countries, improved education of all
participants and ended with consensus development on
clinical approaches to PDA. Furthermore, it provides recommendations for clinicalcare reached by consensus. Additionally, it will serve as a useful foundation for future
SIBEN Consensus on other topics and it could become
valuable as a model to decrease disparity in care and improve outcomes in this and other regions.

*The first two authors contributed similarly in all work leading to this publication.
Correspondence: Sergio G. Golombek, MD, MPH, FAAP.
The Regional...