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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Ductus arteriosus closure is frequently delayed in preterm infants&#44; with an estimated incidence of patency in gestational ages below 30 weeks of up to 60&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">1</span></a> The probability of patency is inversely proportional to the gestational age of the neonate&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">2</span></a> Although patency of ductus arteriosus &#40;PDA&#41; has historically been associated with increased morbidity and mortality in premature newborns&#44;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">3</span></a> the cause&#8211;effect relationship between these unfavorable conditions has not been well established&#46; PDA may merely be an intermediate stage among the hemodynamic changes taking place in the first weeks of life of the preterm infant&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">In recent decades many preterm infants have been treated either prophylactically or actively&#44; with cyclooxygenase inhibitors or with surgical ligation&#46; Therefore&#44; the real significance of PDA and its natural evolution are difficult to determine&#46; Conservative management of PDA has become increasingly common for preterm infants&#44;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">5</span></a> but there is still controversy regarding evaluation and management of PDA&#44; resulting in substantial heterogeneity in clinical practice&#46;<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">6&#44;7</span></a> The main reasons for this approach are that PDA treatments are related to side effects and that almost 30&#37; of preterm infants born at &#60;1000<span class="elsevierStyleHsp" style=""></span>g achieve spontaneous ductus closure in the first week of life&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">2</span></a> Moreover&#44; the long-term improvement associated with treated PDA has yet to be proven&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">6</span></a> It is uncertain whether a more conservative approach can affect premature infants in the long term&#44; and especially those born between 23 and 26 weeks of gestation&#46; Taking into account these facts&#44; in 2011 the authors adopted a more conservative approach to PDA&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">This study was designed to evaluate the differences in treatment received and outcomes of prematurity because of a change in practice before and after the adoption of a new PDA protocol&#44; and to analyze its impact on mortality and the main outcomes&#44; especially in preterm infants born under 26 weeks of gestation&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">The aims of the present study were&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">1&#46;</span><p id="par0025" class="elsevierStylePara elsevierViewall">To evaluate the differences in treatment received because of a change in practice as the main outcome&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">2&#46;</span><p id="par0030" class="elsevierStylePara elsevierViewall">To evaluate the differences in main outcomes because of a change in practice as secondary outcomes&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">3&#46;</span><p id="par0035" class="elsevierStylePara elsevierViewall">To analyze the impact of a more conservative approach to PDA in the most immature subgroup of extreme preterm newborns &#40;born less than 27 weeks of gestation&#41;&#46;</p></li></ul></p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Method</span><p id="par0040" class="elsevierStylePara elsevierViewall">Medical charts of inborn premature infants &#8804;30 weeks of gestation at birth diagnosed with PDA were reviewed&#46; The study comprised patients admitted to the tertiary newborn intensive care units of <span class="elsevierStyleItalic">Hospital Sant Joan de D&#233;u</span> and <span class="elsevierStyleItalic">Parc Taul&#237; Hospital</span> from January 2009 to December 2016&#46; Maternal&#44; perinatal&#44; and neonatal data were collected from medical charts&#46; Patients who died before three days of life&#44; those who had a congenital heart disease&#44; and outborn patients were excluded&#46; Ethical approval for data collection was obtained&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">According to the definition of Vermont Oxford Network &#40;VON&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">8</span></a> PDA was diagnosed based upon at least one of the following findings&#58; left to right or bidirectional ductal shunt on Doppler echo and&#47;or systolic or continuous murmur&#59; and at least two of the following&#58; hyperdynamic precordium&#44; bounding pulses&#44; wide pulse pressure&#44; pulmonary vascular congestion&#44; and cardiomegaly Cardiologists at both centers conducted a color Doppler study of ductal flow in two dimensions with parasternal axis and suprasternal views in all patients&#46; They determined transductal diameter&#44; pulmonary anterograd diastolic flow&#44; left atrial&#58; aorta ratio&#44; aortic retrograde diastolic flow and transductal flow&#46; The authors did not changed the PDA screening method between the periods&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The main outcome of survival-without-morbidity was a composite outcome defined by the absence of any of the secondary outcomes at discharge&#58; chronic lung disease &#40;CLD&#41; defined as supplemental oxygen use at 36 weeks postmenstrual age&#59; severe retinopathy &#40;ROP&#41; grade<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>2 or plus disease according to the international classification<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">8</span></a>&#59; necrotizing enterocolitis &#40;NEC&#41; grade<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>2 according to the Bell classification&#44;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">9</span></a> and severe intraventricular hemorrhage &#40;IVH&#41; grade<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>2 according to the Papile classification&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">10</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">A staging classification of PDA was used to decide whether or not patients received treatment&#46; This classification&#44; which ranges from mild to severe&#44; is based predominantly on the severity and repercussions of the ductal shunting in the cardiovascular&#44; respiratory&#44; and gastrointestinal systems&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">11</span></a> Medical treatment was performed with intravenous ibuprofen at standard dose and surgical treatment implied a classical ligation or the use of a clip&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Additional strategies were also applied to modulate the ductal flow&#46; The authosrs adjusted non-invasive ventilation to a higher positive pressure at the end of the expiration &#40;6&#8211;8<span class="elsevierStyleHsp" style=""></span>cm H<span class="elsevierStyleInf">2</span>O&#41;&#46; An accurate fluid balance &#40;135&#8211;150<span class="elsevierStyleHsp" style=""></span>mL&#47;kg&#47;day&#41; was maintained&#44; ensuring an optimal energy intake &#40;at least 120<span class="elsevierStyleHsp" style=""></span>kcal&#47;kg&#47;day&#41;&#46; The administration of rapid volume bolus was avoided&#46; The authors corrected anemia to a target hematocrit<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>35&#37;&#46; In the presence of any sign of heart failure or pulmonary edema at chest radiography&#44; diuretics were considered&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">In July 2011&#44; the protocol was changed to a more conservative PDA approach as described below&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">In the first period&#44; or P1 &#40;2009&#8211;2011&#41;&#58; medical treatment with ibuprofen was administered if the patient had a PDA according to the VON definition&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">8</span></a> Surgical ligation was performed after failure of two courses of pharmacological treatment if the patient still needed respiratory support &#40;invasive or non-invasive&#41;&#44; and if PDA measured more than 2<span class="elsevierStyleHsp" style=""></span>mm by ultrasound&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">In the second period&#44; or P2 &#40;2012&#8211;2016&#41;&#58; medical treatment with ibuprofen was administered if the patient had any of the following clinical signs of PDA&#58; frequent desaturation &#40;&#62;6<span class="elsevierStyleHsp" style=""></span>times&#47;day&#41; not related to another condition&#44; need for respiratory support &#40;invasive or non-invasive&#41;&#44; systemic hypotension &#40;mean arterial blood pressure below the 3rd percentile for corrected age&#41;&#44; metabolic acidosis &#40;pH<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>7&#46;10&#41;&#44; and pulmonary hemorrhage &#40;evidenced discharge of bloody fluid from the upper respiratory tract or the endotracheal tube and new infiltrates in the chest X-ray&#41; and a PDA of more than 2<span class="elsevierStyleHsp" style=""></span>mm by ultrasound after the first week of life&#46; Surgical ligation of PDA was performed after failure of two courses of pharmacological treatment in the presence of a PDA<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>3<span class="elsevierStyleHsp" style=""></span>mm and cardiopulmonary compromise defined as two unsuccessful attempts of weaning from the respirator or sustained need of inotropic support attributable to the presence of PDA&#46; Moreover&#44; surgical ligation was postponed until the third or fourth week of life whenever possible&#46; Prophylactic medical treatment was not used&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">In both periods&#44; the size of the patent ductus at diagnosis was recorded &#40;in millimeters using color Doppler&#41;&#44; postnatal age &#40;in days&#41; at the beginning of medical treatment&#44; and surgical treatment&#44; if performed&#46; Death before 36 weeks postmenstrual age and composited outcome survival without morbidity were examined&#46; The absence of transductal flow in Doppler ultrasound was considered as a marker of closure&#46; Patent ductus at discharge was considered when the presence of a left to right shunt with a greater diameter than 1&#46;5<span class="elsevierStyleHsp" style=""></span>mm was detected in Doppler ultrasound&#46; These patients were followed up by pediatric cardiologists and the date of definitive closure was recorded &#40;spontaneous or surgical closure&#41;&#46; If surgical closure was required&#44; the type of device used was recorded&#46; Finally&#44; to analyze the impact of a more conservative approach in the most premature neonates &#40;23&#8211;26 weeks&#41;&#44; a stratified analysis was performed&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Perinatal and neonatal risk factors for PDA and outcomes were summarized using descriptive statistics &#40;frequency distribution for categorical data and mean and standard deviation or median and interquartile range for continuous data&#41;&#46; Univariate analysis included the chi-squared test and Fisher&#39;s exact test&#44; as appropriate&#44; for categorical comparisons&#44; and Student&#39;s <span class="elsevierStyleItalic">t</span>-test or the Mann&#8211;Whitney test for continuous variables&#46; An adjusted logistic regression model was used to assess the change in PDA management in survival without morbidity&#46; All hypothesis tests were two sided and <span class="elsevierStyleItalic">p</span>-values &#60;0&#46;05 were considered statistically significant&#46; All data were analyzed using SPSS &#40;IBM Corporation&#44; Statistical Package for the Social Sciences&#44; version 20&#46;0&#44; USA&#41;&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0090" class="elsevierStylePara elsevierViewall">The study sample included 188 infants &#40;61&#37; male&#41; with a mean &#40;&#177;SD&#41; gestational age of 27 &#40;&#177;1&#46;8&#41; weeks and a mean birth weight of 973 &#40;&#177;272&#41;<span class="elsevierStyleHsp" style=""></span>g&#59; of these&#44; 82 &#40;43&#46;6&#37;&#41; were born at &#8804;26 weeks&#46; In the whole cohort&#44; 80&#37; received at least one dose of antenatal steroids&#44; 54&#37; required intubation in the delivery room&#44; 77&#37; received surfactant&#44; and 15&#37; were diagnosed with early sepsis&#46; The authors did not find significant differences comparing the two periods in the main perinatal and clinical risk factors&#44; except for the need for intubation in the delivery room &#40;65&#46;1&#37; in P1 <span class="elsevierStyleItalic">versus</span> 48&#37; in P2&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;027&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">No differences in ductus size at diagnosis were found comparing the two periods&#46; In P2&#44; fewer patients received ibuprofen &#40;number needed to harm<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3 &#91;95&#37; CI&#58; 2&#46;5&#8211;6&#46;2&#93;&#41; and were treated later &#40;6th day&#41;&#44; and fewer patients had surgical closure &#40;number needed to harm<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5 &#91;95&#37; CI&#58; 3&#46;1&#8211;20&#46;3&#93;&#41;&#46; Treated patients in P2 were more immature &#40;26&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;5 weeks <span class="elsevierStyleItalic">vs</span> 27&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;9 weeks&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; and had higher rates of CLD &#40;23&#46;3&#37; <span class="elsevierStyleItalic">versus</span> 6&#46;4&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;017&#41; and severe ROP &#40;19&#37; <span class="elsevierStyleItalic">versus</span> 2&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;007&#41;&#44; but these outcomes were not significant when adjusting for gestational age&#46; A decrease in medical &#40;77&#37; in 2011 <span class="elsevierStyleItalic">versus</span> 40&#37; in 2015&#41; and surgical &#40;18&#37; in 2011 <span class="elsevierStyleItalic">versus</span> 10&#37; in 2015&#41; treatment was observed over time&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">In P2&#44; patients had more days of PDA&#44; and 26 patients &#40;24&#46;5&#37;&#41; were discharged home with a patent ductus &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; Of these&#44; only two patients born before 26 weeks of gestation required transcatheter ductus closure during the follow-up &#40;one at 4 years of age and the other at 10 months&#41;&#46; PDA closure occurred before 12 months of life in 90&#37; of the patients discharged home with a patent ductus&#44; with a median patency of 157 days &#40;122&#8211;241&#41;&#46; None of the patients discharged home with PDA developed pulmonary hypertension during the follow-up&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">No significant differences between periods in main outcomes were found in the need for and duration of respiratory support&#44; rate of nosocomial infection&#44; or length of stay &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46; No differences were found in mortality rates &#40;17&#46;5&#37; <span class="elsevierStyleItalic">versus</span> 15&#46;2&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;690&#41;&#46; Survival-without-morbidity was similar in the two periods when adjusted for gestational age and intubation in the delivery room&#44; adjusted OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;10 &#40;95&#37; CI&#58; 0&#46;55&#8211;2&#46;22&#41;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;783&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">In a subgroup analysis performed to assess the impact of a more conservative approach in the most preterm neonates &#40;23&#8211;26 weeks <span class="elsevierStyleItalic">versus</span> 27&#8211;30 weeks&#41;&#44; it was found that patients born at 23&#8211;26 weeks of gestational age also received less medical treatment &#40;88&#37; <span class="elsevierStyleItalic">versus</span> 66&#46;7&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;045&#41; and surgical treatment &#40;35&#37; <span class="elsevierStyleItalic">versus</span> 24&#46;5&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;375&#41;&#44; although neither was statistically significant&#46; Differences both in the incidence of CLD &#40;50&#37; <span class="elsevierStyleItalic">versus</span> 19&#46;6&#37;&#41; and survival-without-morbidity &#40;20&#37; <span class="elsevierStyleItalic">versus</span> 45&#46;6&#37;&#41; were found&#44; although significance was not reached when adjusting by mechanical ventilation &#62;24<span class="elsevierStyleHsp" style=""></span>h&#44; with an adjusted OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;24 &#40;95&#37; CI&#58; 0&#46;68&#8211;7&#46;35&#41;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;186 &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0115" class="elsevierStylePara elsevierViewall">More conservative management of PDA in this population has shown a 30&#37; reduction in medical and 20&#37; in surgical treatment without changes in mortality or survival-without-morbidity&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Scientific evidence on management of PDA is wide-ranging and sometimes contradictory&#59; even today this condition sees diverse approaches&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">12</span></a> In preterm &#60;32 weeks of gestation age&#44; lower rates of medical treatment &#40;around 20&#37;&#41; and surgical ligation &#40;&#60;10&#37;&#41; have been previously reported&#46;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">11&#44;13&#8211;15</span></a> Chock et al&#46; described similar rates as those of the present study&#59; in era 1&#44; 18&#37; of infants had conservative management <span class="elsevierStyleItalic">versus</span> 39&#37; in era 2 &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">16</span></a> On contrary&#44; Bixler et al&#46; found lower rates of medical treatment&#58; between 20 and 38&#37; use of indomethacin or ibuprofen for PDA treatment in infants &#60;28 weeks of gestation in 2015&#44; and 3&#8211;10&#37; PDA ligation in infants &#60;28 weeks of gestation in 2015&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">13</span></a> Thus&#44; while the medical treatment rate of 56&#37; and the surgical ligation rate of 16&#37; may still be considered high&#44; this population has a wide range of gestational age&#44; with 43&#46;6&#37; of infants born at &#60;27 weeks of gestational age&#46; Perhaps different personal approaches among the neonatologists of these centers had influence on these results&#59; some reticence&#44; especially during the first months after the change in protocol&#44; could have existed&#46; Unfortunately&#44; the authors did not supervise the adherence to the protocol&#44; nor planned a washout period&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">One relevant finding in this study that is worth highlighting is that surgery was avoided in one out of every five patients&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">One of our objectives was also to explore treatment in the most immature patients &#40;23&#8211;27 weeks&#41;&#46; Despite the change of the protocol to a more conservative approach&#44; two thirds of the patients were treated with cyclooxygenase inhibitors and 24&#46;5&#37;&#44; surgically&#46; Lee et al&#46; reported a rate of surgical ligation of 43&#37; in patients with birth weight &#60;750<span class="elsevierStyleHsp" style=""></span>g and of 24&#37; in patients weighing between 715 and 1000<span class="elsevierStyleHsp" style=""></span>g&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">17</span></a> Weisz et al&#46; also reported a rate of 24&#37; for surgical ligation of PDA in extremely premature infants&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">18</span></a></p><p id="par0135" class="elsevierStylePara elsevierViewall">Significant delay in the administration of the first dose of ibuprofen was observed&#44; from 3 days of life in P1 to 6 days in P2&#46; In a population-based cohort study of infants born before 27 weeks of gestation from the EXPRESS study &#40;Extremely Preterm Infants in Sweden Study&#41;&#44; the authors found that a late start of medical treatment was associated with a lower risk of chronic lung disease&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">19</span></a> A significant delay in surgery was not detected as other authors have&#44;<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">12&#44;16</span></a> probably because surgical closure was already performed around the third or the fourth week of life in P1&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">The question of the role of PDA in respiratory&#44; neurological&#44; and gastrointestinal outcomes has been widely discussed<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">6&#44;18&#44;20&#44;21</span></a>&#58; a hemodynamically significant left-to-right shunt could result in a higher pulmonary blood flow and a compromised perfusion of vital organs&#46; Some authors hypothesize that adverse outcomes historically associated with PDA may also be linked to prematurity itself or to some other co-existing condition&#44; such as intrauterine infection or inflammation&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">22</span></a> Benitz concluded that there is no clear evidence that active treatment is beneficial for premature infants because it does not clearly improve mortality or morbidities such as chronic lung disease&#44; necrotizing enterocolitis&#44; intraventricular hemorrhage&#44; and retinopathy&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">23</span></a> Chock et al&#46; compared very low birth weight infants diagnosed with a PDA in two different eras and did not find an increase in adverse clinical outcomes&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">16</span></a> Statistically significant differences between P1 and P2 in the main outcomes classically related to prematurity have not been shown&#44; as can be seen in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">A non-significant reduction in the global incidence of severe necrotizing enterocolitis from 15&#46;5&#37; to 6&#46;9&#37; was found&#46; A significant reduction in the incidence of severe necrotizing enterocolitis from 10&#46;8&#37; to 1&#46;6&#37; was found in patients between 27 and 30 weeks of gestation between periods&#46; In 2011&#44; donor milk was introduced in these hospitals&#44; so the reduction in NEC could more relate to this fact than directly to PDA treatment&#46; Still&#44; a lower use of cyclooxygenase inhibitors in P2 might have played a role&#46;<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">5&#44;20</span></a></p><p id="par0150" class="elsevierStylePara elsevierViewall">Classically&#44; the ductal shunt is thought to have a negative influence on lung development&#59; Mohamed et al&#46; did not find differences in chronic lung disease between two PDA therapeutic periods&#44;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">24</span></a> and Slaughter et al&#46; identified no changes in mortality or moderate-to-severe bronchopulmonary dysplasia in preterm infants &#60;29 weeks of gestation after medical treatment for PDA&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">25</span></a> Conversely&#44; Bixler et al&#46; observed a progressive reduction in all the main morbidities&#44; except for bronchopulmonary dysplasia&#44; in a large population of infants with &#60;30 weeks of gestation from 2006 to 2015&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">11</span></a> In P2&#44; reduction in the incidence of chronic lung disease and survival without morbidity was observed&#44; especially in the most premature patients&#46; Prenatal and postnatal improvement of care in premature infants in recent years&#44; including less intubation in the delivery room and protective ventilatory strategies&#44; probably had an impact on these results&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">The authors detected a non-significant but worrying increase from 5&#46;3&#37; to 11&#46;8&#37; in mortality in the conservative period in patients between 27 and 30 weeks of gestation&#46; Reviewing the medical charts of these infants&#44; two of them born at 27 weeks of gestation died in the first week of life due to respiratory and hemodynamic instability in the context of severe bilateral intraventricular hemorrhage&#46; Another four patients died of causes related to congenital or nosocomial infections&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">With conservative management of PDA&#44; neonatologists must face new challenges&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">26</span></a> PDA might be understood as a type of chronic condition during the hospital stay&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">27</span></a> It was shown in the present study that there was a remarkable increase in the duration of the patency of ductus arteriosus&#46; This might lead in clinical practice to accurate respiratory management&#44; fluid policy&#44; enteral feeding&#44; blood transfusion criteria&#44; and subsequent clinical and echocardiographic monitoring&#46; In this study&#44; a remarkable number of patients were discharged from hospital with a PDA&#46; A question to consider is how having a prolonged left to right shunt can affect brain perfusion and growth status&#46; More follow-up studies are needed to learn what the long-term neurodevelopment outcomes of these infants will be&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">28</span></a></p><p id="par0165" class="elsevierStylePara elsevierViewall">The authors acknowledge some limitations in the present study&#46; As it is a retrospective clinical study&#44; it is not possible to test the causality of relationships or determine whether changes in practice between periods affected the results&#46; There was no washout period between the eras&#59; it is likely that not all neonatologists made the immediate and complete change to a conservative approach&#46; The authors compared the size of PDA between groups&#59; the cohorts were not matched in terms of hemodynamic significance of the PDA&#44; which could have been very interesting&#46; The sample size of the most immature subgroups might have limited the power to detect statistically significant differences&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">In conclusion&#44; this study found that a conservative and more permissive approach in very low birth weight neonates with PDA can in some cases avoid medical and surgical treatments and their potential side effects&#44; without relevant changes in mortality and in survival-without-morbidity&#46; In the youngest patients&#44; rates of medical and surgical treatments for PDA are still high&#44; but more of these patients survive and with fewer associated morbidities&#46; A notable group of patients were discharged home with a permeable ductus without apparent undesirable outcomes&#44; but long-term follow-up is still needed&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">This research did not receive any specific grant from funding agencies in the public&#44; commercial&#44; or non-profit sectors&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conflicts of interest</span><p id="par0180" class="elsevierStylePara elsevierViewall">The authors declare no conflicts of interest&#46;</p></span></span>"
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    "fechaRecibido" => "2018-07-27"
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            0 => "Patent ductus arteriosus"
            1 => "Ductal patency"
            2 => "Preterm infant"
            3 => "Ibuprofen"
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            0 => "Persist&#234;ncia do canal arterial"
            1 => "Pat&#234;ncia do canal"
            2 => "Prematuro"
            3 => "Ibuprofeno"
            4 => "Ligadura cir&#250;rgica"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Management of patent ductus arteriosus is still controversial&#46; This study aimed to describe the impact of a more conservative approach on treatment rates and on main outcomes of prematurity&#44; especially in preterm infants with &#60;26 weeks of gestation&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Method</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Clinical charts review of infants &#8804;30 weeks with patent ductus arteriosus between 2009 and 2016 at two centers&#46; In 2011&#44; the authors changed patent ductus arteriosus management&#58; in first period &#40;2009&#8211;2011&#41;&#44; patients who failed medical treatment underwent surgical closure&#59; in second period &#40;2012&#8211;2016&#41;&#44; only those with cardiopulmonary compromise underwent surgical ligation&#46; Medical treatment&#44; surgical closure&#44; mortality&#44; and survival-without-morbidity were compared&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">This study included 188 patients &#40;27<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2 weeks&#44; 973<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>272 grams&#41;&#59; 63 in P1 and 125 in P2&#46; In P2&#44; significantly lower rates of medical treatment &#40;85&#46;7&#37; P1 <span class="elsevierStyleItalic">versus</span> 56&#37; P2&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; and surgical closure &#40;34&#46;5&#37; P1 <span class="elsevierStyleItalic">versus</span> 16&#46;1&#37; P2&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; were observed&#46; No differences were found in chronic lung disease &#40;28&#46;8&#37; <span class="elsevierStyleItalic">versus</span> 13&#46;9&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;056&#41;&#44; severe retinopathy of prematurity &#40;7&#46;5&#37; <span class="elsevierStyleItalic">versus</span> 11&#46;8&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;403&#41;&#44; necrotizing enterocolitis &#40;15&#46;5&#37; <span class="elsevierStyleItalic">versus</span> 6&#46;9&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;071&#41;&#44; severe intraventricular hemorrhage &#40;25&#46;4&#37; <span class="elsevierStyleItalic">versus</span> 18&#46;4&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;264&#41;&#44; mortality &#40;17&#46;5&#37; <span class="elsevierStyleItalic">versus</span> 15&#46;2&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;690&#41; or survival-without-morbidity adjusted OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;10 &#40;95&#37; CI&#58; 0&#46;55&#8211;2&#46;22&#41;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;783&#46; In P2&#44; 24&#46;5&#37; patients were discharged with patent ductus arteriosus&#46; The subgroup born between 23 and 26 weeks &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>82&#41; showed significant differences&#58; lower incidence of chronic lung disease &#40;50&#37; <span class="elsevierStyleItalic">versus</span> 19&#46;6&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;019&#41; and more survival-without-morbidity &#40;20&#37; <span class="elsevierStyleItalic">versus</span> 45&#46;6&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;028&#41; were found&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A conservative approach in preterm infants with patent ductus arteriosus can avoid medical and surgical treatments&#44; without a significant impact in survival-without-morbidity&#46; However&#44; two-thirds of preterm infants under 26 weeks are still treated&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">O tratamento da persist&#234;ncia do canal arterial ainda &#233; controverso&#46; Nosso objetivo foi descrever o impacto de uma abordagem mais conservadora em nossas taxas de tratamento e nos principais desfechos da prematuridade&#44; especialmente em prematuros com<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>26 semanas de gesta&#231;&#227;o&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todo</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Revis&#227;o de prontu&#225;rios de lactentes com<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>30 semanas e persist&#234;ncia do canal arterial entre 2009-2016 em dois centros&#46; Em 2011&#44; mudamos o manejo da persist&#234;ncia do canal arterial&#58; no primeiro per&#237;odo &#40;2009-2011&#41;&#44; os pacientes que n&#227;o apresentaram sucesso com o tratamento cl&#237;nico foram submetidos a fechamento cir&#250;rgico&#59; no segundo per&#237;odo &#40;2012-2016&#41;&#44; apenas aqueles com comprometimento cardiopulmonar foram submetidos ao fechamento cir&#250;rgico&#46; Comparamos o tratamento cl&#237;nico&#44; fechamento cir&#250;rgico&#44; mortalidade e sobrevida sem morbidade&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Foram inclu&#237;dos 188 pacientes &#40;27<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2 semanas&#44; 973<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>272 gramas&#41;&#59; 63 em P1 e 125 em P2&#46; Em P2&#44; foram observadas taxas significativamente mais baixas de tratamento cl&#237;nico &#40;85&#44;7&#37; no P1 <span class="elsevierStyleItalic">versus</span> 56&#37; no P2&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; e fechamento cir&#250;rgico &#40;34&#44;5&#37; no P1 <span class="elsevierStyleItalic">versus</span> 16&#44;1&#37; no P2&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; N&#227;o foram encontradas diferen&#231;as em rela&#231;&#227;o &#224; doen&#231;a pulmonar cr&#244;nica &#40;28&#44;8&#37; <span class="elsevierStyleItalic">versus</span> 13&#44;9&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;056&#41;&#44; retinopatia grave da prematuridade &#40;7&#44;5&#37; <span class="elsevierStyleItalic">versus</span> 11&#44;8&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;403&#41;&#44; enterocolite necrosante &#40;15&#44;5&#37; <span class="elsevierStyleItalic">versus</span> 6&#44;9&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;071&#41;&#44; hemorragia intraventricular grave &#40;25&#44;4&#37; <span class="elsevierStyleItalic">versus</span> 18&#44;4&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;264&#41;&#44; mortalidade &#40;17&#44;5&#37; <span class="elsevierStyleItalic">versus</span> 15&#44;2&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;690&#41; ou OR ajustado pela sobrevida sem morbidade<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;10 &#40;IC95&#37;&#58; 0&#44;55-2&#44;22&#41;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;783&#46; Em P2&#44; 24&#44;5&#37; dos pacientes receberam alta com persist&#234;ncia do canal arterial&#46; O subgrupo nascido entre 23 a 26 semanas &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>82&#41; apresentou diferen&#231;as significativas&#44; foram encontradas menor incid&#234;ncia de doen&#231;a pulmonar cr&#244;nica &#40;50&#37; <span class="elsevierStyleItalic">versus</span> 19&#44;6&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;019&#41; e maior sobrevida sem morbidade &#40;20&#37; <span class="elsevierStyleItalic">versus</span> 45&#44;6&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;028&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclus&#227;o</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Uma abordagem conservadora em prematuros com persist&#234;ncia do canal arterial pode evitar tratamentos cl&#237;nicos e cir&#250;rgicos&#44; sem um impacto significativo na sobrevida sem morbidade&#46; No entanto&#44; dois ter&#231;os dos prematuros com menos de 26 semanas ainda s&#227;o tratados&#46;</p></span>"
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        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0045">Please cite this article as&#58; Borr&#224;s-Novell C&#44; Riverola A&#44; Aldecoa-Bilbao V&#44; Izquierdo M&#44; Domingo M&#44; Iriondo M&#46; Clinical outcomes after more conservative management of patent ductus arteriosus in preterm infants&#46; J Pediatr &#40;Rio J&#41;&#46; 2020&#59;96&#58;177&#8211;83&#46;</p>"
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                  \t\t\t\t">979 &#40;273&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;684&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Male gender&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40 &#40;63&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">75 &#40;60&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;643&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Antenatal steroids&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">49 &#40;77&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">101 &#40;80&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;626&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Intubation in delivery room&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">41 &#40;65&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">60 &#40;48&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;027&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Surfactant administration&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50 &#40;79&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">94 &#40;75&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;524&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Early sepsis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;19&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;12&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;256&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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                0 => "xTab2266486.png"
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        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Patients&#8217; clinical characteristics and prevalence of main perinatal and neonatal risk factors for patent ductus arteriosus&#46;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
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          0 => array:3 [
            "identificador" => "at2"
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          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Values are <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&#44; mean &#40;standard deviation&#41;&#44; or median &#91;p25&#8211;p75&#93;&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Period 1 &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>63&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Period 2 &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>125&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ductus size &#40;mm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;6 &#40;0&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;6 &#40;0&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;629&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ibuprofen administration&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">54 &#40;85&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">70 &#40;56&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Time medical treatment<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#91;2&#8211;4&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#91;4&#8211;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Surgical closure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20 &#40;34&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18 &#40;16&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Time surgical closure<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24&#46;5 &#91;17&#8211;30&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27 &#91;18&#8211;35&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;766&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Days of PDA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#91;6&#8211;23&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20 &#91;12&#8211;61&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;019&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PDA at discharge&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26 &#40;24&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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                0 => "xTab2266487.png"
              ]
            ]
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          "notaPie" => array:2 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Days of life at the time that medical treatment was started&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0010"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Days of life at the time that surgical closure was performed&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Patent ductus arteriosus &#40;PDA&#41; treatment and duration of its administration&#46; Days of PDA and PDA at discharge&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Values are <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41; or mean &#40;standard deviation&#41;&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Period 1 &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>63&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Period 2 &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>125&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Chronic lung disease<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;28&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;15&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;056&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Severe retinopathy of prematurity<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;7&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;11&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;403&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Necrotizing enterocolitis<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;15&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;6&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;071&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Severe intraventricular hemorrhage<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">d</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;25&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23 &#40;18&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;264&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Nosocomial infection&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26 &#40;44&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">51 &#40;41&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;739&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mechanical ventilation &#40;days&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;238&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Non-invasive ventilation &#40;days&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32 &#40;28&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38 &#40;28&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;248&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Oxygen &#40;days&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">54 &#40;54&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38 &#40;39&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;051&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Length of stay &#40;days&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">89 &#40;36&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">85 &#40;38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;595&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mortality&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;17&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19 &#40;15&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;690&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Survival without morbidity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31 &#40;49&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">71 &#40;56&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;324&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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            1 => array:3 [
              "identificador" => "tblfn0020"
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            2 => array:3 [
              "identificador" => "tblfn0025"
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0030">Severe intraventricular hemorrhage grade 3 and 4 according to the Papille classification&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="3" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">23&#8211;26 weeks &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>82&#41;</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="3" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">27&#8211;30 weeks &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>106&#41;</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">P1&#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">P2 &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>57&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">P1 &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">P2 &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>68&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ibuprofen administration&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22 &#40;88&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38 &#40;66&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;045&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32 &#40;84&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32 &#40;47&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Time medical treatment<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Surgical closure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;35&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;24&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;375&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;34&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;9&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Time surgical closure<a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29 &#40;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28 &#40;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;871&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 &#40;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24 &#40;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;445&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PDA days&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">84 &#40;221&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;199&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;18&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">61 &#40;117&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;023&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PDA at discharge&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;19&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;056&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;28&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Chronic lung disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;19&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;019&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;19&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;13&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;405&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Severe retinopathy of prematurity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;18&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;20&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;858&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;2&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;4&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;602&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Necrotizing enterocolitis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;23&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;13&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;280&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;10&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;1&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;039&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Severe intraventricular hemorrhage&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;44&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;24&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;078&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;13&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;13&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;991&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mortality&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;36&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;19&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;105&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                      "doi" => "10.1053/j.semperi.2011.09.022"
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                        "tituloSerie" => "Semin Perinatol"
                        "fecha" => "2012"
                        "volumen" => "36"
                        "paginaInicial" => "123"
                        "paginaFinal" => "129"
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                    0 => array:2 [
                      "titulo" => "Spontaneous closure of patent ductus arteriosus in infants &#8804;1500<span class="elsevierStyleHsp" style=""></span>g"
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                            0 => "J&#46; Semberova"
                            1 => "J&#46; Sirc"
                            2 => "J&#46; Miletin"
                            3 => "J&#46; Kucera"
                            4 => "I&#46; Berka"
                            5 => "S&#46; Sebkova"
                          ]
                        ]
                      ]
                    ]
                  ]
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                        "tituloSerie" => "Pediatrics"
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                        "volumen" => "140"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28924060"
                            "web" => "Medline"
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                    0 => array:2 [
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                        "tituloSerie" => "Curr Opin Pediatr"
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                        "paginaInicial" => "158"
                        "paginaFinal" => "164"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25689456"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
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                            2 => "P&#46;J&#46; McNamara"
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                        "fecha" => "2016"
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                            3 => "L&#46; Mbuagbaw"
                            4 => "T&#46; Vanniyasingam"
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                      "titulo" => "Committee on Fetus and Newborn&#44; American Academy of Pediatrics&#46; Patent ductus arteriosus in preterm infants"
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                            2 => "J&#46;M&#46; Trzaski"
                            3 => "K&#46;R&#46; Johnson"
                            4 => "S&#46; Lainwala"
                            5 => "B&#46;T&#46; Campbell"
                          ]
                        ]
                      ]
                    ]
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                    0 => array:2 [
                      "doi" => "10.1038/pr.2016.166"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Res"
                        "fecha" => "2016"
                        "volumen" => "80"
                        "paginaInicial" => "785"
                        "paginaFinal" => "792"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27509008"
                            "web" => "Medline"
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              "identificador" => "bib0180"
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                    0 => array:2 [
                      "titulo" => "Manual of operations&#58; Part 2&#46; Data definitions &#38; infant data forms&#46; Release 19&#46;0"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
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                    0 => array:2 [
                      "titulo" => "Neonatal necrotizing enterocolitis&#58; therapeutic decisions based upon clinical staging"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;J&#46; Bell"
                            1 => "J&#46;L&#46; Ternberg"
                            2 => "R&#46;D&#46; Feigin"
                            3 => "J&#46;P&#46; Keating"
                            4 => "R&#46; Marshall"
                            5 => "L&#46; Barton"
                          ]
                        ]
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                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/00000658-197801000-00001"
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                        "tituloSerie" => "Ann Surg"
                        "fecha" => "1978"
                        "volumen" => "187"
                        "paginaInicial" => "1"
                        "paginaFinal" => "7"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/413500"
                            "web" => "Medline"
                          ]
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              "identificador" => "bib0190"
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                    0 => array:2 [
                      "titulo" => "Incidence and evolution of the subependymal intraventricular hemorrhage&#58; a study of infants with weights &#60;1500 grams"
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                        0 => array:2 [
                          "etal" => false
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                            2 => "R&#46; Burstein"
                            3 => "H&#46; Koffler"
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                        "tituloSerie" => "J Pediatr"
                        "fecha" => "1978"
                        "volumen" => "92"
                        "paginaInicial" => "529"
                        "paginaFinal" => "534"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/305471"
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                          ]
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                ]
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              "identificador" => "bib0195"
              "etiqueta" => "11"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Towards a rational management of patent ductus arteriosus&#58; the need for disease staging"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
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                    0 => array:2 [
                      "doi" => "10.1136/adc.2007.118117"
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                        "tituloSerie" => "Arch Dis Child Fetal Neonatal Ed"
                        "fecha" => "2007"
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                        "paginaInicial" => "F424"
                        "paginaFinal" => "F427"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17951547"
                            "web" => "Medline"
                          ]
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                      "titulo" => "Patent ductus arteriosus treatment in very preterm infants&#58; a European population-based cohort study &#40;EPICE&#41; on variation and outcomes"
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                            1 => "A&#46; Gudmundsdottir"
                            2 => "R&#46;F&#46; Maier"
                            3 => "L&#46; Toome"
                            4 => "J&#46; Zeitlin"
                            5 => "M&#46; Bonet"
                          ]
                        ]
                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000454798"
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                        "tituloSerie" => "Neonatology"
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                    0 => array:2 [
                      "titulo" => "Changes in the diagnosis and management of patent ductus arteriosus from 2006 to 2015 in United States neonatal intensive care units"
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                    0 => array:2 [
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                          "etal" => false
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                            3 => "H&#46;C&#46; Lee"
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                        "paginaFinal" => "450"
                        "link" => array:1 [
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                      "titulo" => "Changing management of the patent ductus arteriosus&#58; effect on neonatal outcomes and resource utilization"
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                            2 => "J&#46;P&#46; Palma"
                            3 => "T&#46;M&#46; Luh"
                            4 => "N&#46;A&#46; Wang"
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                        "paginaFinal" => "995"
                        "link" => array:1 [
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28376547"
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                      "titulo" => "Hospital variation in medical and surgical treatment of patent ductus arteriosus"
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                          "etal" => false
                          "autores" => array:5 [
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                            1 => "D&#46; Durand"
                            2 => "B&#46; Danielsen"
                            3 => "G&#46; Villarin"
                            4 => "R&#46; Powers"
                          ]
                        ]
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                    0 => array:2 [
                      "doi" => "10.1055/s-0034-1387931"
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                        "tituloSerie" => "Am J Perinatol"
                        "fecha" => "2015"
                        "volumen" => "32"
                        "paginaInicial" => "379"
                        "paginaFinal" => "386"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25241108"
                            "web" => "Medline"
                          ]
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Association of patent ductus arteriosus ligation with death or neurodevelopmental impairment among extremely preterm infants"
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                          "etal" => true
                          "autores" => array:6 [
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                            2 => "E&#46; Rosenberg"
                            3 => "M&#46; Jang"
                            4 => "L&#46; Ly"
                            5 => "P&#46;T&#46; Church"
                          ]
                        ]
                      ]
                    ]
                  ]
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                    0 => array:2 [
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                        "tituloSerie" => "JAMA Pediatr"
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                        "volumen" => "171"
                        "paginaInicial" => "443"
                        "paginaFinal" => "449"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28264088"
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              ]
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                    0 => array:2 [
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
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                            2 => "S&#46; H&#229;kansson"
                            3 => "M&#46; Norman"
                            4 => "K&#46; K&#228;llen"
                            5 => "A&#46; Bonamy"
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                        "tituloSerie" => "Neonatology"
                        "fecha" => "2015"
                        "volumen" => "107"
                        "paginaInicial" => "87"
                        "paginaFinal" => "92"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25412681"
                            "web" => "Medline"
                          ]
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                ]
              ]
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              "identificador" => "bib0240"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "The use of non-steroidal anti-inflammatory drugs for patent ductus arteriosus closure in preterm infants"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "W&#46;E&#46; Benitz"
                            1 => "S&#46; Bhomal"
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                        ]
                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.siny.2017.07.004"
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                        "tituloSerie" => "Semin Fetal Neonatal Med"
                        "fecha" => "2017"
                        "volumen" => "22"
                        "paginaInicial" => "302"
                        "paginaFinal" => "307"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28724506"
                            "web" => "Medline"
                          ]
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                ]
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              "identificador" => "bib0245"
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                    0 => array:2 [
                      "titulo" => "Non-pharmacological management of a hemodynamically significant patent ductus arteriosus"
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                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Smith"
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                            2 => "A&#46;F&#46; El-Khuffash"
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                    ]
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                    0 => array:2 [
                      "doi" => "10.1016/j.siny.2018.03.008"
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                        "tituloSerie" => "Semin Fetal Neonatal Med"
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                        "paginaFinal" => "249"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29580939"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Patent ductus arteriosus of the preterm infant"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46;E&#46; Hamrick"
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                        "volumen" => "125"
                        "paginaInicial" => "1020"
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                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20421261"
                            "web" => "Medline"
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                          "etal" => false
                          "autores" => array:1 [
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                        "tituloSerie" => "J Perinatol"
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                        "volumen" => "30"
                        "paginaInicial" => "241"
                        "paginaFinal" => "252"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20182439"
                            "web" => "Medline"
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              ]
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                    0 => array:2 [
                      "titulo" => "Patent ductus arteriosus in premature infants&#58; to treat or not to treat&#63;"
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                            3 => "K&#46; Alyami"
                            4 => "A&#46;N&#46; Ibrahim"
                            5 => "H&#46; Aly"
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                        "paginaInicial" => "652"
                        "paginaFinal" => "657"
                        "link" => array:1 [
                          0 => array:2 [
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                            "web" => "Medline"
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                      "titulo" => "Comparative effectiveness of nonsteroidal anti-inflammatory drug treatment versus no treatment for patent ductus arteriosus in preterm infants"
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                          "etal" => false
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                            2 => "T&#46;B&#46; Newman"
                            3 => "M&#46;A&#46; Klebanoff"
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                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28046188"
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                        "tituloSerie" => "J Paediatr Child Health"
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                        "paginaFinal" => "758"
                        "link" => array:1 [
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                          0 => array:2 [
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