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What is a hemodynamically significant PDA in preterm infants?

Jennifer L Shepherd1, Shahab Noori1

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Defining a hemodynamically significant patent ductus arteriosus (hsPDA) lacks consensus. This review discusses variables for assessing hsPDA, proposing an individualized approach considering clinical, echocardiographic, and age-related factors.

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Area of Science:

  • Neonatal Cardiology
  • Pediatric Cardiovascular Research

Background:

  • The definition of a hemodynamically significant patent ductus arteriosus (hsPDA) remains inconsistent.
  • Accurate identification of hsPDA is crucial for appropriate clinical management in neonates and infants.

Purpose of the Study:

  • To review and discuss the key variables used to define hsPDA.
  • To propose a comprehensive and individualized approach for assessing hemodynamic significance.

Main Methods:

  • Review of existing literature on hsPDA definitions and echocardiographic indices.
  • Analysis of the strengths and weaknesses of various assessment methods.

Main Results:

  • Multiple clinical, echocardiographic, and objective variables contribute to defining hsPDA.
  • Existing echocardiographic indices have varying degrees of utility and limitations.

Conclusions:

  • An individualized approach integrating multiple factors is recommended for hsPDA assessment.
  • Patient vulnerability, including gestational and chronological age, is a critical consideration.