title: Echocardiographic prediction of patent ductus arteriosus in need of therapeutic intervention.
abstract: OBJECTIVE
  To evaluate the efficacy of various echocardiographic markers in predicting a patent ductus arteriosus (PDA) in need of treatment.
  
  
  METHODS
  Forty-five preterm infants with a mean (SD) gestational age of 27.7 (1.9) weeks underwent echocardiography at a postnatal age of 24 ± 6 and 72 ± 6 h. Four echocardiographic markers were studied: ductus diameter, ductal flow Doppler curves, the left atrial to aortic root (LA/Ao) ratio and Doppler pixels representing ductal shunting.
  
  
  RESULTS
  Twenty-eight infants had a PDA with a detectable left-to-right shunt. Of these, 12 (43%) were treated for a shunt through the PDA. Ductal diameter was the most accurate echocardiographic marker when it came to predicting a significant shunt, with a sensitivity of 89%, a specificity of 70%, a positive likelihood ratio of 2.97 and a negative likelihood ratio of 0.16 at the age of 72 h. The efficacy of the method at 72 h of age was 84%. The corresponding efficacy of the pulsatile Doppler curve was 72%, percentage of green colour pixels 63% and the LA/Ao ratio 53%.
  
  
  CONCLUSIONS
  Ductus diameter appears to be the most important variable in determining the need for therapeutic intervention for PDA in preterm infants.
authors.affiliation: Department of Paediatrics, Halmstad Hospital, Sweden. solweig.harling@med.lu.se
authors.forename: S
authors.initials: S
authors.lastname: Harling
authors.forename: I
authors.initials: I
authors.lastname: Hansen-Pupp
authors.forename: A
authors.initials: A
authors.lastname: Baigi
authors.forename: E
authors.initials: E
authors.lastname: Pesonen
mesh_terms: D004374:Ductus Arteriosus, Patent / Q000000981:diagnostic imaging* / Q000628:therapy; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D014463:Ultrasonography