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Updated: Jan 23, 2026

Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography

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Impacto de la persistencia del conducto arterioso no hemodinámicamente significativo en la función pulmonar en

Patrick D Evers¹, Austin F Menezes¹, Brian Scottoline²

¹Division of Pediatric Cardiology, Oregon Health and Sciences University, Portland, Oregon.

The Journal of pediatrics

|January 21, 2026

Abstracto

Objective:

To quantify the impact of non-hemodynamically significant PDA (non-hsPDA) on pulmonary function in neonates.

Study Design:

We analyzed a retrospective cohort of very low birthweight (<1500 g) infants born <32 weeks' gestation admitted to a single tertiary neonatal intensive care unit between 2019-2023 who underwent both echocardiography and pulmonary function testing (PFT) at approximately 34 weeks postmenstrual age. Infants with ventricular or atrial septal defects were excluded. Passive respiratory compliance (Crs) was compared among infants with hsPDA, non-hsPDA, and age-matched controls without PDA using one-sided t-tests and ANOVA, with multivariable regression controlling for birth weight and length.

Results:

Twenty-four infants were analyzed (8 hsPDA, 8 non-hsPDA, 8 controls). Mean Crs was significantly reduced in both hsPDA (0.83 ± 0.34 mL/cmH₂O/kg) and non-hsPDA (0.92 ± 0.21) groups compared with controls (1.23 ± 0.34; p<0.05). The presence of PDA demonstrated a stepwise inverse relationship with Crs that persisted after adjustment for covariates.

Conclusions:

Even non-hemodynamically significant PDAs are associated with measurable reductions in pulmonary compliance among preterm infants. These findings suggest that current binary classifications of PDA significance may underestimate pulmonary impact and support reevaluation of management thresholds for "non-significant" shunts.

Palabras clave:

Displasia broncopulmonar Ecocardiografía Lactante Persistencia del conducto arterioso Prematuro Mecánica respiratoria

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