Early colour Doppler duct diameter and symptomatic patent ductus arteriosus in a cyclo-oxygenase inhibitor naïve population

Heuchan, Anne Marie and Young, David (2013) Early colour Doppler duct diameter and symptomatic patent ductus arteriosus in a cyclo-oxygenase inhibitor naïve population. Acta Paediatrica, 102 (3). pp. 254-257. ISSN 0803-5253

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Abstract

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.

ORCID iDs

Heuchan, Anne Marie and Young, David ORCID logoORCID: https://orcid.org/0000-0002-3652-0513;