Impact of different hemodynamic states of patent ductus arteriosus on cerebral, mesenteric, and renal perfusion in preterm infants: a doppler ultrasound analysis

Q: What are the key findings of this study?

Hemodynamically significant PDA impaired intestinal and renal perfusion in preterm infants, increasing superior mesenteric artery and renal artery resistance indices.

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Patent ductus arteriosus in preterm infants (n=103). Intervention: Hemodynamically significant patent ductus arteriosus (hsPDA) vs. Non-hemodynamically significant patent ductus arteriosus (non-hsPDA). Primary outcome: Superior mesenteric artery resistance index (RI) (p=<0.001).

Q: What question did this study set out to answer?

To evaluate the impact of different hemodynamic states of patent ductus arteriosus on cerebral, mesenteric, and renal perfusion in preterm infants using bedside Doppler ultrasound.

Zhenhai Qiu; Liping Lai; Xia Zhang; Weixiao Hu

doi:10.1186/s12887-026-06565-4

January 31, 2026BMC PediatricsOpen Access

Impact of different hemodynamic states of patent ductus arteriosus on cerebral, mesenteric, and renal perfusion in preterm infants: a doppler ultrasound analysis

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Key result

Hemodynamically significant PDA is linked to impaired gut and renal perfusion in preterm infants.

P<0.001
n=103

Key Points

To evaluate the impact of different hemodynamic states of patent ductus arteriosus on cerebral, mesenteric, and renal perfusion in preterm infants using bedside Doppler ultrasound.
Retrospective single-center study evaluating 103 preterm infants with patent ductus arteriosus, categorized into hemodynamically significant PDA (hsPDA, n=50) and non-hsPDA (n=53).
Bedside Doppler ultrasound assessed peak systolic velocity, end-diastolic velocity (EDV), mean velocity (MV), and resistive index (RI) in the anterior cerebral artery (ACA), superior mesenteric artery (SMA), and renal artery (RA).
In the SMA, infants with hsPDA exhibited significantly lower EDV (5.7 ± 2.9 cm/s vs. 8.8 ± 2.1 cm/s, P < 0.001) and MV (16.0 ± 2.4 cm/s vs. 18.6 ± 2.2 cm/s, P < 0.001), along with higher RI (0.85 ± 0.08 vs. 0.77 ± 0.05, P < 0.001).
In the RA, the hsPDA group had significantly lower EDV (7.2 ± 2.2 cm/s vs. 10.1 ± 2.1 cm/s, P < 0.001) and higher RI (0.81 ± 0.06 vs. 0.75 ± 0.05, P < 0.001), whereas ACA hemodynamic parameters did not differ significantly between groups.
The incidence of Stage II/III necrotizing enterocolitis was significantly higher in the hsPDA group compared with the non-hsPDA group (P = 0.024), while rates of intraventricular hemorrhage and renal insufficiency showed no significant differences.

Study Design

Type

Observational (n=103)

Blinding

Single-blind

Multicenter

No

PICO

P

Population

103 preterm infants (gestational age < 37 weeks) with patent ductus arteriosus admitted to a single NICU in China, free of other congenital heart defects or preexisting severe organ lesions, evaluated within the first week of admission.

E

Exposure / Comparator

Hemodynamically significant patent ductus arteriosus (hsPDA) vs Non-hemodynamically significant patent ductus arteriosus (non-hsPDA)

O

Primary Outcome

Superior mesenteric artery resistance index (RI), p=<0.001

Main Result

Absolute Event Rate: 0.85% vs 0.77%

p-value: p=<0.001

Limitations

Single-center retrospective study with a small sample size
Potential interobserver and intra-observer variability due to multiple sonographers over 4 years without formal variability analysis
Did not specifically focus on infants with bi-directional or right-to-left shunting PDA
Did not collect data on diastolic flow reversal in the descending aorta, left ventricular output, or PDA diameter for hsPDA definition
Unable to perform separate outcome analysis between inborn and outborn infants
Lack of advanced real-time perfusion monitoring techniques such as near-infrared spectroscopy or amplitude-integrated electroencephalography

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Implication

Analysis reveals diverse effects of patent ductus arteriosus on organ perfusion in preterm infants, suggesting important monitoring implications.

Abstract

Different hemodynamic states of PDA have distinct impacts on organ perfusion in preterm infants. Bedside Doppler ultrasound provides a sensitive tool for early detection of these hemodynamic alterations.

Discussion

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Cite This Study

Qiu et al. (2026) conducted an observational in Patent ductus arteriosus in preterm infants (n=103). Hemodynamically significant patent ductus arteriosus (hsPDA) vs. Non-hemodynamically significant patent ductus arteriosus (non-hsPDA) was evaluated on Superior mesenteric artery resistance index (RI) (p=<0.001). Hemodynamically significant PDA impaired intestinal and renal perfusion in preterm infants, increasing superior mesenteric artery and renal artery resistance indices.

synapsesocial.com/papers/6980ffa4c1c9540dea8124cb https://doi.org/10.1186/s12887-026-06565-4

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Impact of different hemodynamic states of patent ductus arteriosus on cerebral, mesenteric, and renal perfusion in preterm infants: a doppler ultrasound analysis

Key Points

Study Design

PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Impact of different hemodynamic states of patent ductus arteriosus on cerebral, mesenteric, and renal perfusion in preterm infants: a doppler ultrasound analysis

Key Points

Study Design

PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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