Document Detail


Echocardiography as a guide for patent ductus arteriosus ibuprofen treatment and efficacy prediction.
MedLine Citation:
PMID:  21760564     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE:: To evaluate echocardiography criteria in predicting the response to ibuprofen treatment. DESIGN:: A prospective cohort study of preterm infants untreated or treated with ibuprofen for patent ductus arteriosus. SETTING:: Three academic neonatal intensive care units. PATIENTS:: Two hundred fifty-two preterm infants of 27-31 wks gestation. INTERVENTIONS:: 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. MEASUREMENTS AND MAIN 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:
Roxane Desandes; Jean-Marc Jellimann; Mahmoud Rouabah; Fouad Haddad; Emmanuel Desandes; Farid Boubred; Denis Semama; Rachel Vieux; Jean-Michel Hascoët
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-7-14
Journal Detail:
Title:  Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies     Volume:  -     ISSN:  1529-7535     ISO Abbreviation:  -     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-7-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100954653     Medline TA:  Pediatr Crit Care Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
From the Department of Neonatology (RD, JMJ, MR, FH, RV, JMH), Maternite Regionale Universitaire, Nancy, France; Department of Epidemiology (ED), Centre Alexis Vautrin, Vandoeuvre, France; Department of Neonatology (FB), Hôpital de la Conception, AP-HM, Marseille, France; and Department of Neonatology (DS), Hôpital d'enfants CHU, Dijon, France.
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