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Early haemodynamically significant patent ductus arteriosus does not predict future persistence in extremely preterm
Karl Wilhelm Olsson1, Anders Jonzon1, Richard Sindelar1
1Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Early hemodynamically significant patent ductus arteriosus (hsPDA) did not predict persistent PDA in extremely preterm infants. However, the need for mechanical ventilation and low ductal flow velocity were associated with persistent PDA.
Area of Science:
- Neonatology
- Pediatric Cardiology
- Perinatal Medicine
Background:
- Patent ductus arteriosus (PDA) is common in extremely preterm infants.
- Early identification of persistent PDA is crucial for timely intervention.
- Hemodynamically significant PDA (hsPDA) is a key concern in this population.
Purpose of the Study:
- To determine if early hsPDA predicts persistent PDA in extremely preterm infants.
- To identify early indicators of persistent PDA in this vulnerable group.
Main Methods:
- Prospective observational study of 60 infants (22-27 weeks gestational age).
- Daily echocardiography during the first three days of life.
- Pharmacological treatment initiated for hsPDA; persistent PDA defined post-treatment.
Main Results:
- Early hsPDA (days 2-7) was not associated with future persistent PDA (p=1.000).
- Persistent PDA occurred in 30% of infants.
- Mechanical ventilation (p=0.025), high mean airway pressure (p=0.020), and low ductal Vmax (p=0.024) on day two predicted persistent PDA.
Conclusions:
- Early hsPDA is not a reliable predictor of persistent PDA in extremely preterm infants.
- Assisted ventilation and low ductal Vmax on day two are associated with persistent PDA.
- These findings may aid in refining management strategies for preterm neonates.
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