Resistive indices of cerebral arteries in very preterm infants: values throughout stay in the neonatal intensive care unit and impact of patent ductus arteriosus

Abstract Background Patent ductus arteriosus poses diagnostic and therapeutic dilemma for clinicians, diagnosis of persistent PDA, and determination of its clinical and hemodynamic significance are challenging. The aim of this study is to determine the prevalence of PDA in preterm infants admitted to our NICU, to report cardiac and respiratory complications of PDA, and to study the management strategies and their subsequent outcomes. Result Echocardiography was done for 152 preterm babies admitted to neonatal intensive care unit (NICU) on day 3 of life. Eighty-seven (57.2%) preterms had PDA; 54 (62.1%) non-hemodynamically significant PDA (non-hsPDA), and 33 (37.9%) hemodynamically significant PDA. Hemodynamically significant PDA received medical treatment (paracetamol 15 mg/kg/6 h IV for 3 days). Follow-up echocadiography was done on day 7 of life. Four babies died before echo was done on day 7. Twenty babies (68.9%) achieved closure after 1st paracetamol course. Nine babies received 2nd course paracetamol. Follow-up echo done on day 11 of life showed 4 (13.7%) babies achieved successful medical closure after 2nd paracetamol course; 5 babies failed closure and were assigned for surgical ligation. The group of non-hsPDA showed spontaneous closure after conservative treatment. Pulmonary hemorrhage was significantly higher in hsPDA group. Mortality was higher in hsPDA group than non-hsPDA group. Conclusion Echocardiographic evaluation should be done for all preterms suspected clinically of having PDA. We should not expose vulnerable population of preterm infants to medication with known side effects unnecessarily; we should limit medical closure of PDA to hsPDA. Paracetamol offers several important therapeutic advantages options being well tolerated and having more favorable side effects profile.

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Management and outcomes of concurrent patent ductus arteriosus and necrotising enterocolitis in preterm infants in a surgical neonatal intensive care unit

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/archdischild.2011.300164.31 ◽

2011 ◽

Vol 96 (Supplement 1) ◽

pp. Fa25-Fa26

Author(s):

A. Stewart ◽

A. Heuchan ◽

N. Patel ◽

G. Walker

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Patent Ductus Arteriosus ◽

Neonatal Intensive Care Unit ◽

Preterm Infants ◽

Neonatal Intensive Care ◽

Ductus Arteriosus ◽

Necrotising Enterocolitis ◽

Patent Ductus

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PIH5 Clinical and Economic Evaluation of ORAL Versus Intravenous Ibuprofen Therapy in Preterm Infants with Patent Ductus Arteriosus in the Neonatal Intensive Care Unit in Qatar

Value in Health Regional Issues ◽

10.1016/j.vhri.2020.07.232 ◽

2020 ◽

Vol 22 ◽

pp. S45

Author(s):

D. Abushanab ◽

P. Abdul Rouf ◽

M. Al Hail ◽

S. Al-Shaibi ◽

B. Viswanathan ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Economic Evaluation ◽

Patent Ductus Arteriosus ◽

Neonatal Intensive Care Unit ◽

Preterm Infants ◽

Neonatal Intensive Care ◽

Ductus Arteriosus ◽

Intravenous Ibuprofen ◽

Patent Ductus

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PO-0455 Resistive Index (ri) Of Cerebral Arteries In Very Preterm Infants: Reference Values And Impact Of Patent Ductus Arteriosus

Archives of Disease in Childhood ◽

10.1136/archdischild-2014-307384.1096 ◽

2014 ◽

Vol 99 (Suppl 2) ◽

pp. A394.1-A394

Author(s):

GM Ecury-Goossen ◽

MMA Raets ◽

FA Camfferman ◽

J van Rosmalen ◽

IKM Reiss ◽

...

Keyword(s):

Patent Ductus Arteriosus ◽

Preterm Infants ◽

Reference Values ◽

Ductus Arteriosus ◽

Cerebral Arteries ◽

Resistive Index ◽

Very Preterm Infants ◽

Very Preterm ◽

Patent Ductus

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The Silent Patent Ductus Arteriosus

PEDIATRICS ◽

10.1542/peds.72.4.580b ◽

1983 ◽

Vol 72 (4) ◽

pp. 580-581

Author(s):

IRAJ A. KASHANI ◽

RICHARD E. SWENSSON ◽

T. ALLEN MERRITT

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Patent Ductus Arteriosus ◽

Neonatal Intensive Care Unit ◽

Preterm Infants ◽

Neonatal Intensive Care ◽

Ductus Arteriosus ◽

Systolic Murmur ◽

Practical Approach ◽

Patent Ductus

To the Editor.— We read with interest the article by Ellison et al1 on evaluation of preterm infants for patent ductus arteriosus. While commending the study for its elaborate design, we believe that in the modern neonatal intensive care unit there is a need for a less cumbersome and more practical approach to this common problem. The criteria for detecting patent ductus arteriosus (PDA) in the presence of a continuous or systolic murmur presented in this paper are well founded, and the figures on the incidence of PDA are in agreement with some studies that have primarily relied on the murmur as the key feature.2,3

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Patent ductus arteriosus, systemic NT-proBNP concentrations and development of bronchopulmonary dysplasia in very preterm infants: retrospective data analysis from a randomized controlled trial

BMC Pediatrics ◽

10.1186/s12887-021-02750-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Solomiia Potsiurko ◽

Dmytro Dobryanskyy ◽

Lesya Sekretar

Keyword(s):

Randomized Controlled Trial ◽

Patent Ductus Arteriosus ◽

Preterm Infants ◽

Roc Curve ◽

Controlled Trial ◽

Ductus Arteriosus ◽

Very Preterm Infants ◽

Very Preterm ◽

Randomized Controlled ◽

Patent Ductus

Abstract Background Patent ductus arteriosus (PDA) is a common complication in very preterm infants. It is known that there is an association between PDA and development of bronchopulmonary dysplasia (BPD) or death before the postmenstrual age (PMA) of 36 weeks, but this association remains one of the most controversial aspects of the problem. The study aimed to evaluate the relationship between PDA, serum NT-proBNP levels at 2–3 and 8–9 days of life, and BPD/death in very preterm infants. Methods Data of 52 preterm infants with a gestational age < 32 weeks, chronological age < 72 h, and PDA diameter > 1.5 mm, enrolled in a randomized controlled trial, were used for the retrospective analysis. All patients underwent daily echocardiographic and two serum NT-proBNP measurements within the first 10 days after birth. Two groups of infants were formed retrospectively at PMA of 36 weeks depending on the outcome, BPD (n = 18)/death (n = 7) or survival without BPD (n = 27). Receiver operator characteristic (ROC) curve was used to evaluate the predictive performance of serum NT-proBNP levels for BPD/death occurrence. Results The percentage of infants who received pharmacological treatment for PDA did not differ between the groups. Based on the area under the ROC curve, serum NT-proBNP levels on the 2–3 day of life (AUC = 0.71; 95% confidence interval (CI): 0.56–0.9; p = 0.014)) and on the 8–9 day of life (AUC = 0.76; 95% CI: 0.6–0.9; p = 0.002) could reliably predict BPD/death in very preterm infants who had PDA diameter > 1.5 mm in the first 72 h of life. Hemodynamically significant PDA (hsPDA) was significantly more often detected in newborns with BPD/death, however, treatment of infants with hsPDA did not reduce the incidence of BPD/death. Conclusions In very preterm infants with PDA > 1.5 mm at the age of 24–48 h, serum NT-proBNP concentration could reliably predict the development of BPD or death, regardless of the persistence of PDA, with the highest diagnostic value at 8–9 days. Trial registration This study is registered in ClinicalTrials.gov - NCT03860428 on March 4, 2019.

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