A clinical and noninvasive diagnostic scheme identified hemodynamically significant patent ductus arteriosus in 20.2% of 1,689 premature infants with birth weight <1,750 g.
Observational (n=1,689)
Yes
As a first step in a multicenter, collaborative project to study the role of indomethacin in the management of patent ductus arteriosus in premature infants, a diagnostic scheme was developed, on an a priori basis, by a consensus of the participating neonatologists and pediatric cardiologists. The scheme, which utilizes clinical and noninvasive findings, was designed to detect infants with a "hemodynamically significant" patent ductus arteriosus (PDA). Among 1,689 infants with birth weight less than 1,750 g who were monitored during the first year of the study, 342 (20.2%) met the criteria for PDA. Rates were higher for smaller infants (42% with birth weight less than 1,000 g) than for larger infants (7% with birth weight 1,500 to 1,750 g). Although study protocol did not require a direct procedure to confirm the diagnosis of PDA, a marked decrease in the presence of most criteria was noted following surgical ligation of the ductus. Although the echocardiographic criterion (ratio of left atrium to aorta LA/Ao greater than or equal to 1.15) proved to have a low specificity for PDA, the data suggest that the overall scheme led to a very low rate of false-positive diagnosis. Following the application of the scheme for 1 year at 13 clinical centers, it has been shown to be a highly acceptable means of detecting infants with PDA.
Ellison et al. (1983) conducted an observational in Patent ductus arteriosus (n=1,689). Diagnostic scheme for patent ductus arteriosus was evaluated on Detection of hemodynamically significant patent ductus arteriosus. A clinical and noninvasive diagnostic scheme identified hemodynamically significant patent ductus arteriosus in 20.2% of 1,689 premature infants with birth weight <1,750 g.