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Early echocardiography does not predict subsequent treatment of symptomatic patent ductus arteriosus in extremely preterm infants
Author(s) -
Pereira Sujith S.,
Kempley Stephen T.,
Shah Divyen K.,
Morris Joan K.,
Sinha Ajay K.
Publication year - 2018
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.14361
Subject(s) - medicine , ductus arteriosus , gestation , logistic regression , cohort , gestational age , pediatrics , obstetrics , pregnancy , genetics , biology
Aim To determine whether early echocardiographic ductal parameters identified infants who subsequently received medical or surgical treatment of the patent ductus arteriosus ( PDA ). Methods Infants <29 weeks had PDA size in 2D and colour, flow velocity and patterns obtained on days 1 and 3. Infants were followed up to identify those subsequently receiving treatment for symptomatic PDA by clinicians who were unaware of scan results. Receiver operator characteristics curves and logistic regression were performed. Results Sixty infants were studied. Mean ( SD ) gestation and birthweight were 25.8 (1.5) weeks and 817 (190) grams, respectively. Twenty‐four (40%) infants received medical treatment, and nine (15%) infants received surgical ligation of PDA at a median age of 12 and 37 days, respectively. PDA size on days 1 and 3, change in ductal size between days 1 and 3, flow pattern/velocity did not predict whether infants subsequently received medical or surgical management of PDA . Using logistic regression, gestation (p = 0.006) was the only factor that predicted whether infants would subsequently receive medical or surgical treatment for PDA in this cohort. Conclusion Echocardiographic ductal parameters on day 1 or 3 did not identify infants who received PDA treatment. Gestation was the most powerful predictor for receiving medical or surgical treatment of PDA .