title: Early colour Doppler duct diameter and symptomatic patent ductus arteriosus in a cyclo-oxygenase inhibitor naïve population.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Neonatal Medicine, The Royal Hospital for Sick Children, Glasgow, Scotland, UK. anemarie.heuchan@ggc.scot.nhs.uk
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Heuchan
authors.forename: David
authors.initials: D
authors.lastname: Young
mesh_terms: D000367:Age Factors; D016861:Cyclooxygenase Inhibitors / Q000627:therapeutic use*; D004374:Ductus Arteriosus, Patent / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy; D018618:Echocardiography, Doppler, Color; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy; D008297:Male; D011237:Predictive Value of Tests; D012189:Retrospective Studies
chemical_list: D016861:Cyclooxygenase Inhibitors