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Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
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Closure of patent ductus arteriosus and respiratory function changes in ventilated preterm infants

Beatrice Marangoni1, Fahad M S Arattu Thodika2, Mahesh Nanjundappa2

  • 1Neonatal Intensive Care Centre, King's College Hospital NHS Foundation Trust, London, UK; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, Milan, Italy.

Respiratory Physiology & Neurobiology
|April 3, 2026
PubMed

Insights

Treatment for a patent ductus arteriosus (PDA) in preterm infants increased oxygen needs and worsened ventilation-perfusion matching. However, it effectively reduced intrapulmonary right-to-left shunting, improving respiratory function.

Area of Science:

  • Neonatal Medicine
  • Pediatric Cardiology
  • Respiratory Physiology

Background:

  • Patent ductus arteriosus (PDA) is common in preterm infants.
  • Treatment options include pharmacological and surgical interventions.
  • Respiratory effects of PDA treatment require further elucidation.

Purpose of the Study:

  • To investigate respiratory function changes after PDA treatment.
  • To analyze ventilation and perfusion parameters post-intervention.
  • To report changes using composite respiratory physiological indices.

Main Methods:

  • Retrospective cohort study of ventilated infants (<30 weeks gestational age).
  • Data collected over two years at a tertiary Neonatal Unit.
  • Calculated fraction of inspired oxygen (FIO2), VQ ratio, shunt, and CO2 gradient pre- and post-PDA treatment.

Main Results:

  • Thirty-nine preterm infants were analyzed.
  • FIO2 significantly increased post-treatment (p=0.010).
  • VQ ratio (p=0.034) and shunt decreased significantly post-treatment, while CO2 gradient showed no significant change.

Conclusions:

  • PDA treatment in ventilated preterm infants increases oxygen requirement.
  • Ventilation-perfusion matching worsened post-treatment.
  • Intrapulmonary right-to-left shunting was reduced by PDA treatment.
Abstract

Keywords:
IbuprofenParacetamolPrematurityShuntVentilation to perfusion

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