Abstract
METHODS: A retrospective study of infants <29 weeks of gestation with early colour Doppler assessment of PDA diameter, in whom PDA was managed conservatively, without cyclo-oxygenase inhibitor (COI) treatment.
RESULTS: Gestation and birthweight, [median (range)], were 26 (23-28) weeks and 865 (500-1440) g, respectively. Symptomatic PDA developed in 20 (68.9%) infants, with 11 (37.9%) referred for PDA ligation at 24 (17-30) days. Symptoms resolved spontaneously in 7 infants (24.1%) at 19 (7-32) days. There were 6 (20.7%) deaths, including four early neonatal deaths with large PDA. Early colour Doppler PDA diameter >1.5 mm (n = 20) predicted development of symptomatic PDA (sensitivity 91%, specificity 100%), but symptoms resolved spontaneously without treatment in 30%. There was a significant linear correlation (p < 0.001) with increasing early PDA diameter and the development of more persistent PDA symptoms, early neonatal mortality and morbidity.
CONCLUSIONS: In our (COI)-naïve population, the mortality and morbidity associated with prolonged exposure to unrestricted ducts are high. Not all infants with early PDA diameter >1.5 mm have persistent symptomatic PDA, but early PDA diameter could be utilized to identify those infants at greatest risk of adverse outcome associated with PDA.
| Language | English |
|---|---|
| Pages | 254-257 |
| Number of pages | 4 |
| Journal | Acta Paediatrica |
| Volume | 102 |
| Issue number | 3 |
| Early online date | 4 Jan 2013 |
| DOIs | |
| Publication status | Published - 31 Mar 2013 |
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Keywords
- cyclo-oxygenase inhibitors (COIs)
- echocardiography
- patent ductus arteriosus (PDA)
- PDA ligation
- premature
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Early colour Doppler duct diameter and symptomatic patent ductus arteriosus in a cyclo-oxygenase inhibitor naïve population. / Heuchan, Anne Marie; Young, David.
In: Acta Paediatrica, Vol. 102, No. 3, 31.03.2013, p. 254-257.Research output: Contribution to journal › Article
TY - JOUR
T1 - Early colour Doppler duct diameter and symptomatic patent ductus arteriosus in a cyclo-oxygenase inhibitor naïve population
AU - Heuchan, Anne Marie
AU - Young, David
PY - 2013/3/31
Y1 - 2013/3/31
N2 - AIMS: To examine the relationship between early duct diameter and patent ductus arteriosus (PDA) symptoms. METHODS: A retrospective study of infants <29 weeks of gestation with early colour Doppler assessment of PDA diameter, in whom PDA was managed conservatively, without cyclo-oxygenase inhibitor (COI) treatment. RESULTS: Gestation and birthweight, [median (range)], were 26 (23-28) weeks and 865 (500-1440) g, respectively. Symptomatic PDA developed in 20 (68.9%) infants, with 11 (37.9%) referred for PDA ligation at 24 (17-30) days. Symptoms resolved spontaneously in 7 infants (24.1%) at 19 (7-32) days. There were 6 (20.7%) deaths, including four early neonatal deaths with large PDA. Early colour Doppler PDA diameter >1.5 mm (n = 20) predicted development of symptomatic PDA (sensitivity 91%, specificity 100%), but symptoms resolved spontaneously without treatment in 30%. There was a significant linear correlation (p < 0.001) with increasing early PDA diameter and the development of more persistent PDA symptoms, early neonatal mortality and morbidity. CONCLUSIONS: In our (COI)-naïve population, the mortality and morbidity associated with prolonged exposure to unrestricted ducts are high. Not all infants with early PDA diameter >1.5 mm have persistent symptomatic PDA, but early PDA diameter could be utilized to identify those infants at greatest risk of adverse outcome associated with PDA.
AB - AIMS: To examine the relationship between early duct diameter and patent ductus arteriosus (PDA) symptoms. METHODS: A retrospective study of infants <29 weeks of gestation with early colour Doppler assessment of PDA diameter, in whom PDA was managed conservatively, without cyclo-oxygenase inhibitor (COI) treatment. RESULTS: Gestation and birthweight, [median (range)], were 26 (23-28) weeks and 865 (500-1440) g, respectively. Symptomatic PDA developed in 20 (68.9%) infants, with 11 (37.9%) referred for PDA ligation at 24 (17-30) days. Symptoms resolved spontaneously in 7 infants (24.1%) at 19 (7-32) days. There were 6 (20.7%) deaths, including four early neonatal deaths with large PDA. Early colour Doppler PDA diameter >1.5 mm (n = 20) predicted development of symptomatic PDA (sensitivity 91%, specificity 100%), but symptoms resolved spontaneously without treatment in 30%. There was a significant linear correlation (p < 0.001) with increasing early PDA diameter and the development of more persistent PDA symptoms, early neonatal mortality and morbidity. CONCLUSIONS: In our (COI)-naïve population, the mortality and morbidity associated with prolonged exposure to unrestricted ducts are high. Not all infants with early PDA diameter >1.5 mm have persistent symptomatic PDA, but early PDA diameter could be utilized to identify those infants at greatest risk of adverse outcome associated with PDA.
KW - cyclo-oxygenase inhibitors (COIs)
KW - echocardiography
KW - patent ductus arteriosus (PDA)
KW - PDA ligation
KW - premature
UR - http://www.scopus.com/inward/record.url?scp=84873412042&partnerID=8YFLogxK
U2 - 10.1111/apa.12103
DO - 10.1111/apa.12103
M3 - Article
VL - 102
SP - 254
EP - 257
JO - Acta Paediatrica
T2 - Acta Paediatrica
JF - Acta Paediatrica
SN - 0803-5253
IS - 3
ER -