Document Detail


Echocardiographic assessment of patent ductus arteriosus shunt flow pattern in premature infants.
MedLine Citation:
PMID:  9279181     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: To identify the patent ductus arteriosus (PDA) shunt flow pattern using Doppler echocardiography; and to assess whether it could be used to predict the development of clinically significant PDA. METHODS: Premature infants weighing under 1500 g, who required mechanical ventilation, and in whom daily echocardiography could be performed from day 1 until the ductus closed, and on day 7 to confirm closure, were studied. The PDA shunt flow was identified from four Doppler patterns, and the closed pattern of a closed duct was also presented. Clinically significant PDA was diagnosed when there was colour Doppler echocardiographic evidence of left to right ductal shunt associated with at least two of the following clinical signs: heart murmur (systolic or continuous); persistent tachycardia (heart rate > 160/min); hyperactive precordial pulsation; bounding pulses; and radiographic evidence of cardiomegaly or pulmonary congestion. RESULTS: Of 68 infants enrolled into this study, clinically significant PDA developed in 31. The most recordable sequence of transition change of shunt flow pattern for clinically significant PDA was: pulmonary hypertension pattern, to growing pattern, to pulsatile pattern, to closing pattern, to closed pattern. And that for non-clinically significant PDA was: pulmonary hypertension pattern, to closing pattern, to closed pattern. The growing and the pulsatile patterns were mostly documented in infants with clinically significant PDA. The first documented growing pattern to predict clinically significant PDA gave a sensitivity of 64.5% and a specificity of 81.1%; the first documented pulsatile pattern gave a sensitivity of 93.5% and a specificity of 100%. CONCLUSION: Doppler echocardiographic assessment of PDA shunt flow pattern during the first 4 days of life is useful for predicting the development of clinically significant PDA in premature infants. At that stage, the closing or closed Doppler pattern indicates that infants are not at risk of developing clinically significant PDA; the growing or pulsatile Doppler pattern indicates a continuing risk of developing clinically significant PDA.
Authors:
B H Su; T Watanabe; M Shimizu; M Yanagisawa
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of disease in childhood. Fetal and neonatal edition     Volume:  77     ISSN:  1359-2998     ISO Abbreviation:  Arch. Dis. Child. Fetal Neonatal Ed.     Publication Date:  1997 Jul 
Date Detail:
Created Date:  1997-09-11     Completed Date:  1997-09-11     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9501297     Medline TA:  Arch Dis Child Fetal Neonatal Ed     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  F36-40     Citation Subset:  AIM; IM    
Affiliation:
Department of Neonatology, Tokyo Metropolitan Tsukiji Maternity Hospital, Japan.
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MeSH Terms
Descriptor/Qualifier:
Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
Ductus Arteriosus, Patent / drug therapy,  physiopathology,  ultrasonography*
Echocardiography, Doppler, Color*
Humans
Hypertension, Pulmonary / ultrasonography
Indomethacin / therapeutic use
Infant, Newborn
Infant, Premature
Longitudinal Studies
Predictive Value of Tests
Prognosis
Regional Blood Flow
Risk
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents, Non-Steroidal; 53-86-1/Indomethacin
Comments/Corrections

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