Key result
Guiding PDA management with clinical signs and echo shows only ~23% of preterm infants require treatment.
Why the study?
Does basing treatment decisions on clinical signs and symptoms alongside echocardiography reduce unnecessary medical treatments for PDA in preterm infants?
Cohort (n=39)
Does basing treatment decisions on clinical signs and symptoms alongside echocardiography reduce unnecessary medical treatments for PDA in preterm infants?
Correlating clinical signs with echocardiographic findings for PDA treatment decisions in preterm infants may prevent unnecessary medical treatments, as many close spontaneously.
May reduce unnecessary PDA treatment in preterm infants; hypothesis-generating pending randomized outcome trials.
OBJECTIVE: The objective of this study was to find out the percentage of preterm infants that needed treatment for patent ductus arteriosus (PDA), when treatment decision was based on clinical signs and symptoms, besides echocardiographic findings. METHODS: Daily echocardiographic evaluation was conducted in 39 preterms ≤29(6/7) weeks' gestation. Patients with ductus arteriosus were closely followed-up for clinical symptoms of PDA for treatment decision until ductus arteriosus was closed either spontaneously or by treatment. RESULTS: PDA was found in 25 (64%) infants. Mean gestational age and birth weight (BW) of the patients with PDA were 27.8 ± 1.2 and 998 ± 221 g, respectively. PDA closed spontaneously or had minimal ductal shunting before any signs and symptoms attributable to PDA were observed in 16 (41%) infants. Mean ductus size/BW ratio and mean left atrial/aortic root ratio were significantly higher in 9 (23%) symptomatic patients (2.06 ± 0.75 versus 1.32 ± 0.75 mm, p = 0.012 and 1.31 ± 0.52 versus 1.19 ± 0.2 mm, p = 0.043, respectively). PDA closure was observed after the first dose of ibuprofen in six of nine patients. CONCLUSION: Correlation of clinical signs with echocardiographic findings for the decision of PDA treatment can be appropriate to prevent unnecessary medical treatments.
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Alan et al. (2013) conducted a cohort in Patent ductus arteriosus (n=39). Clinical signs and symptoms combined with echocardiographic findings was evaluated on Percentage of preterm infants needing treatment for patent ductus arteriosus. Basing patent ductus arteriosus treatment decisions on clinical signs alongside echocardiography identified that only 23% of preterm infants required treatment, while 41% closed spontaneously.
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