title: Serial echocardiography in very preterm infants: a pilot randomized trial.
abstract: OBJECTIVE
  To determine whether routine echocardiography increases diagnosis and treatment for patent ductus arteriosus (PDA) and whether randomized nondisclosure is a feasible strategy for studying PDA management.
  
  
  METHODS
  Two-centre, pilot randomized, controlled trial. 88 infants with birth weights ≤1250 grams and gestational ages ≤30 weeks were randomized to disclosure or nondisclosure of serial echocardiogram findings. Echocardiograms were performed at 3-5 and 7-10 days of life. The primary outcome was time to regain birth weight.
  
  
  RESULTS
  100% of echocardiograms in the disclosure group were disclosed; 16% (echocardiogram #1) and 29% (echocardiogram #2) were disclosed in the nondisclosure group. There was a statistically nonsignificant decrease in drug therapy for PDA in the nondisclosure group (adjusted odds ratio [AOR] 0.56, 95% confidence interval [CI] 0.24-1.34). There was no difference in time to regain birth weight or in other important neonatal outcomes. However, infants in the nondisclosure group were more likely to demonstrate appropriate weight loss and then regain birth weight within 7-14 days (AOR 2.64, 95% CI 1.08-6.44).
  
  
  CONCLUSIONS
  Randomized nondisclosure of echocardiograms is a feasible strategy for evaluation of approaches to PDA management in very preterm infants. Avoidance of routine echocardiography may reduce drug therapy for PDA without adverse clinical effects.
authors: The Children's Hospital of Philadelphia, Philadelphia, PA, USA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. demauro@email.chop.edu.
authors: Sara B
authors: SB
authors: DeMauro
authors: Meryl S
authors: MS
authors: Cohen
authors: Sarah J
authors: SJ
authors: Ratcliffe
authors: Soraya
authors: S
authors: Abbasi
authors: Barbara
authors: B
authors: Schmidt
mesh_terms: D030881:Disclosure; D004374:Ductus Arteriosus, Patent / Q000000981:diagnostic imaging*; D004452:Echocardiography; D005240:Feasibility Studies; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D010865:Pilot Projects; D011296:Prenatal Diagnosis / Q000009:adverse effects*; D015430:Weight Gain
keywords: Echocardiogram; Echocardiography; Patent ductus arteriosus; Very low birth weight infant; Very premature infant
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