Echocardiographic predictors of symptomatic patent ductus arteriosus in extremely-low-birth-weight preterm neonates.
OBJECTIVE
Identify echocardiographic parameters at <or=4 day postnatal that predict the subsequent need for closure of a clinically significant patent ductus arteriosus (sPDA) in extremely-low-birth-weight neonates (ELBW).


METHODS
Serial echocardiograms obtained in 115 ELBW at <or=10 day postnatal were examined to estimate PDA size using the PDA:left pulmonary artery (LPA) diameter ratio: >or=1 indicated a large PDA, <1 but >or=0.5 moderate, and <0.5 small. Sensitivity, specificity, and positive predictive values (PPV) were determined for ELBW <27 weeks and >or=27 weeks gestational age.


RESULTS
Neonates with moderate to large PDA at <or=4 day had 15-times greater likelihood of requiring treatment for sPDA than those with a small PDA (95% confidence interval (CI): 5.6-41). Sensitivity, specificity and PPV of the PDA:LPA at <27 weeks was 80, 86 and 92%, respectively.


CONCLUSIONS
A moderate to large PDA determined from the PDA:LPA ratio at <or=4 day postnatal identifies neonates <27 week gestation who subsequently require closure of a PDA.
Ramos
F G
FG
Division of Cardiology, Department of Pediatrics, UT Southwestern Medical Center, Dallas, TX, USA.
Rosenfeld
C R
CR
Roy
L
L
Koch
J
J
Ramaciotti
C
C
D004374:Ductus Arteriosus, Patent / Q000145:classification / Q000000981:diagnostic imaging*; D005865:Gestational Age; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D011237:Predictive Value of Tests; D012039:Regional Blood Flow; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014463:Ultrasonography