Clinical and echocardiographic diagnosis of patent ductus arteriosus in premature neonates.
The ductus arteriosus frequently fails to close in premature neonates. Considerable difference in opinion exists around what signifies a hemodynamically significant patent ductus arteriosus (PDA) and how reliable clinical signs are in determining the degree of the left-to-right shunting. Although reliance on clinical signs alone could delay the diagnosis of a PDA, there is insufficient evidence to suggest that early treatment improves outcome. Echocardiography is often used as the gold standard for diagnosing a PDA. A combination of echocardiographic measurements may assist in the early diagnosis of a PDA with a hemodynamically significant degree of left-to-right shunting, especially in extremely premature babies, where closure can be significantly delayed. Decision to treat PDA should be based on a combination of clinical signs and echocardiographic parameters. Monitoring B-type natriuretic peptide may be useful in the diagnosing neonates with symptomatic PDA.
Chiruvolu
Arpitha
A
Department of Pediatrics, Division of Neonatology, Baylor University Medical Center, Dallas, Texas 75246, USA. Arpitha.Chiruvolu@baylorhealth.edu
Punjwani
Poonam
P
Ramaciotti
Claudio
C
D004374:Ductus Arteriosus, Patent / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging; D004452:Echocardiography; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011446:Prospective Studies
D020097:Natriuretic Peptide, Brain