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DOI: 10.1055/s-0037-1605576
Tale of Two Patent Ductus Arteriosus Severity Scores: Similarities and Differences
Publikationsverlauf
18. Mai 2017
07. Juli 2017
Publikationsdatum:
08. August 2017 (online)
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Abstract
Introduction Several echocardiographic scoring systems have been developed to assess the severity of patent ductus arteriosus (PDA) shunting in preterm infants.
Objective The objective of this study was to compare the ability of two different scoring systems to evaluate the hemodynamic significance of the PDA and to predict long-term PDA-associated morbidities.
Subjects El-Khuffash cohort (previously described) was derived from a multicenter, prospective, observational study conducted in tertiary neonatal intensive care units in Ireland, Canada, and Australia.
Results A total of 141 infants with a mean gestational age of 26 ± 1.4 weeks and a mean birth weight of 952 ± 235 g were evaluated on day 2 of life. The two scores were well correlated with each other and both scores positively predicted chronic lung disease/death in this population.
Conclusion There appears to be an overall stepwise progression in the incidence of poor outcome parameters from “closed” to “borderline” to “hemodynamically significant” PDA. Both the El-Khuffash and Shaare Zedek scores are predictive of PDA-associated morbidities.
Note
Daniel Fink and Afif El-Khuffash contributed equally to this study. All authors reviewed the article for important intellectual contents and approved the final version. All authors agree to be accountable for all aspects of the work. No honorarium, grant, or other form of payment was received to produce the article.
Funding
None.
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References
- 1 El Hajjar M, Vaksmann G, Rakza T, Kongolo G, Storme L. Severity of the ductal shunt: a comparison of different markers. Arch Dis Child Fetal Neonatal Ed 2005; 90 (05) F419-F422
- 2 Schena F, Francescato G, Cappelleri A. , et al. Association between hemodynamically significant patent ductus arteriosus and bronchopulmonary dysplasia. J Pediatr 2015; 166 (06) 1488-1492
- 3 Sehgal A, Paul E, Menahem S. Functional echocardiography in staging for ductal disease severity: role in predicting outcomes. Eur J Pediatr 2013; 172 (02) 179-184
- 4 El-Khuffash A, James AT, Corcoran JD. , et al. A patent ductus arteriosus severity score predicts chronic lung disease or death before discharge. J Pediatr 2015; 167 (06) 1354-1361.e2
- 5 Kluckow M, Evans N. Early echocardiographic prediction of symptomatic patent ductus arteriosus in preterm infants undergoing mechanical ventilation. J Pediatr 1995; 127 (05) 774-779
- 6 Su BH, Peng CT, Tsai CH. Echocardiographic flow pattern of patent ductus arteriosus: a guide to indomethacin treatment in premature infants. Arch Dis Child Fetal Neonatal Ed 1999; 81 (03) F197-F200
- 7 Broadhouse KM, Price AN, Durighel G. , et al. Assessment of PDA shunt and systemic blood flow in newborns using cardiac MRI. NMR Biomed 2013; 26 (09) 1135-1141
- 8 Martin CG, Snider AR, Katz SM, Peabody JL, Brady JP. Abnormal cerebral blood flow patterns in preterm infants with a large patent ductus arteriosus. J Pediatr 1982; 101 (04) 587-593
- 9 Breatnach CR, Franklin O, McCallion N, El-Khuffash A. The effect of a significant patent ductus arteriosus on Doppler flow patterns of preductal vessels: an assessment of the brachiocephalic artery. J Pediatr 2017; 180: 279-281.e1
- 10 Dudell GG, Gersony WM. Patent ductus arteriosus in neonates with severe respiratory disease. J Pediatr 1984; 104 (06) 915-920
- 11 Thankavel PP, Rosenfeld CR, Christie L, Ramaciotti C. Early echocardiographic prediction of ductal closure in neonates ≤ 30 weeks gestation. J Perinatol 2013; 33 (01) 45-51
- 12 Sellmer A, Bjerre JV, Schmidt MR. , et al. Morbidity and mortality in preterms with PDA. Arch Dis Child Fetal Neonatal 2012; 98: F505
- 13 Koch J, Hensley G, Roy L, Brown S, Ramaciotti C, Rosenfeld CR. Prevalence of spontaneous closure of the ductus arteriosus in neonates at a birth weight of 1000 grams or less. Pediatrics 2006; 117 (04) 1113-1121