title: Echocardiography as a guide for patent ductus arteriosus ibuprofen treatment and efficacy prediction.
abstract: OBJECTIVE
  To evaluate echocardiography criteria in predicting the response to ibuprofen treatment.
  
  
  METHODS
  A prospective cohort study of preterm infants untreated or treated with ibuprofen for patent ductus arteriosus.
  
  
  METHODS
  Three academic neonatal intensive care units.
  
  
  METHODS
  Two hundred fifty-two preterm infants of 27-31 wks gestation.
  
  
  METHODS
  Ibuprofen treatment within the first 5 days of life was indicated when at least two out of four conventional echocardiography criteria were observed: ductal diameter >2 mm, left-right ductal shunt maximum velocity <2 m/sec, mean flow velocity in left pulmonary artery >0.4 m/sec, and end-diastolic flow velocity in left pulmonary artery >0.2 m/sec.
  
  
  RESULTS
  Of the infants analyzed, 135 had a closed ductus at an average age of 1.9 ± 0.9 days, and 43 had an open ductus but <2 predefined criteria. Seventy-four infants (29%) received ibuprofen on day 2.2 ± 1.1. Sixteen infants failed ibuprofen and nine had to undergo surgical ligation. The left-right ductal shunt maximum velocity criterion had the best negative predictive value for treatment response, while the ductal diameter criterion had the best positive predictive value.
  
  
  CONCLUSIONS
  Echocardiography may be a useful tool to help patent ductus arteriosus management. A combined use of ductal diameter and left-right ductal shunt maximum velocity criteria allows a more accurate prediction of the response of infants with patent ductus arteriosus to ibuprofen treatment.
authors.affiliation: Department of Neonatology, Maternite Regionale Universitaire, Nancy, France.
authors.forename: Roxane
authors.initials: R
authors.lastname: Desandes
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Jellimann
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Rouabah
authors.forename: Fouad
authors.initials: F
authors.lastname: Haddad
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Desandes
authors.forename: Farid
authors.initials: F
authors.lastname: Boubred
authors.forename: Denis S
authors.initials: DS
authors.lastname: Semama
authors.forename: Rachel
authors.initials: R
authors.lastname: Vieux
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Hascoët
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D015331:Cohort Studies; D004334:Drug Administration Schedule; D004374:Ductus Arteriosus, Patent / Q000000981:diagnostic imaging / Q000188:drug therapy*; D018618:Echocardiography, Doppler, Color; D018619:Echocardiography, Doppler, Pulsed; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use*; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000000981:diagnostic imaging; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D007052:Ibuprofen