Background: 

There seems to also be a downwards trend towards non-intervention of PDA in extremely premature babies as it is felt to be manifestation of prematurity. 

Aims: 
1.	To evaluate change in practise for management of PDA in preterm babies over 16 years.
2.	To evaluate acute neonatal outcomes over 16 years, including death, bronchopulmonary dysplasia, grade IV intraventricular haemorrhage, necrotising enterocolitis, and retinopathy of prematurity requiring laser treatment.

Method: Retrospective observational study of all infants 28 weeks gestation admitted to a tertiary neonatal unit over 16 years (total infants 1061 from 2002 to 2017)

Results: Overall 269 infants (24 %) received medical treatment for PDA. 33% of babies born  < 28 weeks were medically treated for PDA during period 2002-2009 (Epoch 1) compared to only 17% of babies during 2010-2017 (Epoch 2). All-cause mortality during Epoch 1 in babies < 28 weeks was 18% and incidence of ROP needing laser intervention was 3.9%; these were 16% and 5.4% respectively during Epoch 2.  Response to PDA treatment was analysed over 7 years (2010-2016). 17% of PDAs had complete closure after treatment, and 50% became restrictive.  In our unit the median time of treatment of PDA has remained constant (median 14 days of life – range 12-19 days). 

Conclusions: Our unit has always followed a symptomatic strategy for the management of PDAs. Though our time of initiation of treatment for PDA has not changed we are treating significantly fewer babies < 28 weeks We have noted an increasing trend in incidence of ROP over the last 16 years, however this has not been corrected for a possible increased complexity in case load. We observed improving trend in mortality.

0079 - HAVE WE BECOME TOLERANT TO PDA? A RETROSPECTIVE DESCRIPTIVE STUDY OVER 16 YEARS