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Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
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Clinical and echocardiographic characteristics associated with evolution of patent ductus arteriosus in preterm

A K Saha1, S K Sardar1, B Majhi2

  • 1Department of Neonatology, Institute of Post Graduate Medical Education & Research and SSKM Hospital, Kolkata, India.

Journal of Neonatal-Perinatal Medicine
|May 23, 2022
PubMed

Insights

Persistent ductus arteriosus in preterm infants is linked to clinical and echocardiographic factors. Echocardiography on day 3 can predict future ductus arteriosus behavior, guiding treatment decisions.

Area of Science:

  • Neonatal Medicine
  • Pediatric Cardiology
  • Medical Imaging

Background:

  • Persistence of ductus arteriosus (PDA) is a significant concern in preterm infants.
  • Functional echocardiography aids in managing PDA treatment strategies.
  • Understanding PDA evolution is crucial for clinical decision-making.

Purpose of the Study:

  • To assess clinical and echocardiographic parameter trends in preterm infants (≤1250g) with evolving ductus arteriosus.
  • To evaluate the association of these parameters with persistent PDA.
  • To identify predictors of PDA persistence.

Main Methods:

  • Prospective observational study of 143 preterm infants.
  • Serial assessment of clinical events and functional echocardiography.
  • Classification into groups: no PDA, spontaneously closed PDA (within 7 days), and persistent PDA.

Main Results:

  • 53.4% of infants with PDA at birth did not achieve spontaneous closure within the first week.
  • PDA Doppler flow pattern on day 3 significantly predicted future ductus behavior.
  • Growing and pulsatile flow patterns were most frequent in the persistent PDA group.
  • PDA diameter and LA/Ao ratio strongly correlated with other echocardiographic variables.

Conclusions:

  • Persistence of ductus arteriosus in preterm infants is associated with significant clinical and echocardiographic findings.
  • Day 3 PDA Doppler flow pattern is a key marker for predicting ductus arteriosus behavior.
  • Echocardiographic parameters show significant inter-correlations, aiding in judicious PDA treatment in neonates.
Abstract

Keywords:
Functional echocardiographypatent ductus arteriosuspretermvery low birth weight

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