alexa Echocardiographic prediction of patent ductus arteriosus in need of therapeutic intervention.


Journal of Pulmonary & Respiratory Medicine

Author(s): Harling S, HansenPupp I, Baigi A, Pesonen E

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Abstract AIM: To evaluate the efficacy of various echocardiographic markers in predicting a patent ductus arteriosus (PDA) in need of treatment. METHODS: Forty-five preterm infants with a mean (SD) gestational age of 27.7 (1.9) weeks underwent echocardiography at a postnatal age of 24 ± 6 and 72 ± 6 h. Four echocardiographic markers were studied: ductus diameter, ductal flow Doppler curves, the left atrial to aortic root (LA/Ao) ratio and Doppler pixels representing ductal shunting. RESULTS: Twenty-eight infants had a PDA with a detectable left-to-right shunt. Of these, 12 (43\%) were treated for a shunt through the PDA. Ductal diameter was the most accurate echocardiographic marker when it came to predicting a significant shunt, with a sensitivity of 89\%, a specificity of 70\%, a positive likelihood ratio of 2.97 and a negative likelihood ratio of 0.16 at the age of 72 h. The efficacy of the method at 72 h of age was 84\%. The corresponding efficacy of the pulsatile Doppler curve was 72\%, percentage of green colour pixels 63\% and the LA/Ao ratio 53\%. CONCLUSION: Ductus diameter appears to be the most important variable in determining the need for therapeutic intervention for PDA in preterm infants. © 2010 The Author(s)/Acta Paediatrica © 2010 Foundation Acta Paediatrica. This article was published in Acta Paediatr and referenced in Journal of Pulmonary & Respiratory Medicine

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