Association of low shunt burden from PDA and adverse outcomes in premature infants

Compare the incidence of death or adverse respiratory outcome in patients with low shunt burden from PDA to those with no PDA and evaluate secondary outcomes associated with PDA between groups.

Retrospective cohort study of all infants born <30 weeks gestation from 8/2018 to 5/2023 with TNE in the first postnatal week. Two groups: no PDA burden and low PDA burden. Primary outcome was composite of death or adverse respiratory outcome.

112 infants [no PDA (n = 69), low PDA burden (n = 43)] with mean gestational age and birth weight 27 ± 2 weeks and 1006 ± 310 g, respectively, were included. Baseline demographics were comparable with no difference in primary outcome (p = 0.2).

Prolonged exposure to low-volume PDA shunt was not associated with increased risk of death or abnormal respiratory outcome. Findings highlight the importance of redefining eligibility criteria for PDA trials, based on adjudication of shunt volume, to limit enrollment to patients with moderate- to high-volume shunts.