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DOI: 10.1055/s-0038-1677475
Wide Pulse Pressure Is Not Associated with Patent Ductus Arteriosus in the First Week of Life
Funding None.Publication History
23 October 2018
02 December 2018
Publication Date:
15 January 2019 (online)
![](https://www.thieme-connect.de/media/ajp/201913/lookinside/thumbnails/10-1055-s-0038-1677475_180551-1.jpg)
Abstract
Objectives Widened pulse pressure is generally associated with patent ductus arteriosus (PDA). Surprisingly, this is often not true for preterm infants during the first week of life when systolic and diastolic pressures are both reduced and pulse pressure may remain unchanged.
Study Design This is a retrospective, observational review of individual blood pressure (BP) parameters preterm neonates <30 weeks' gestational age during the first week of life as correlated with ductal patency and severity.
Results Sixteen preterm neonates had a closed ductus on initial echocardiogram during the first week of life; 30 had a PDA that was open but hemodynamically insignificant; and 16 were found to have a hemodynamically significant PDA. Pulse pressure showed no correlation (p = 0.266) with the degree of ductal patency, whereas diastolic BP was best correlated with ductal severity (p < 0.001).
Conclusion We found that low diastolic pressures are better correlated with ductal patency and severity than is pulse pressure in preterm neonates during the first week of life.
Authors' Contributions
F.M. and C.H. conceptualized and designed the study, drafted the initial article, and reviewed and revised the article. A.B.-N., Y.K., I.S., and D.F. designed the data collection instruments, collected data, performed the initial analyses, and reviewed and revised the article. All authors approved the final article as submitted and agree to be accountable for all aspects of the work.
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References
- 1 Jobe A. The respiratory system. In: Martin RJ, Fanaroff AA, Walsh MC. , eds. Neonatal Perinatal Medicine: Diseases of the Fetus and Infant, 9th ed. St. Louis, Missouri: Elsevier, Mosby; 2011: 1115
- 2 Bernstein D. Cyanotic congenital heart diseases: the left-to right shunt lesions. In: Kliegman RM, Stanton B, Schor N, St Geme J, Behrman RE. , eds. Nelson Textbook of Pediatrics, 19th ed. Philadelphia: W.B. Saunders Company; 2011: 1559-1561
- 3 Evans N, Moorcraft J. Effect of patency of the ductus arteriosus on blood pressure in very preterm infants. Arch Dis Child 1992; 67 (10 Spec No): 1169-1173
- 4 Fink D, El-Khuffash A, McNamara PJ, Nitzan I, Hammerman C. Tale of two patent ductus arteriosus severity scores: similarities and differences. Am J Perinatol 2018; 35 (01) 55-58
- 5 Gillam-Krakauer M, Reese J. Diagnosis and management of patent ductus arteriosus. Neoreviews 2018; 19 (07) e394-e402
- 6 Ratner I, Perelmuter B, Toews W, Whitfield J. Association of low systolic and diastolic blood pressure with significant patent ductus arteriosus in the very low birth weight infant. Crit Care Med 1985; 13 (06) 497-500
- 7 Lubetzky R, Mandel D, Mimouni FB. , et al. Indomethacin-induced early patent ductus arteriosus closure cannot be predicted by a decrease in pulse pressure. Am J Perinatol 2004; 21 (05) 257-261
- 8 Evans N, Iyer P. Change in blood pressure after treatment of patent ductus arteriosus with indomethacin. Arch Dis Child 1993; 68 (5 Spec No): 584-587
- 9 Sonesson SE, Lundell BP, Herin P. Changes in intracranial arterial blood flow velocities during surgical ligation of the patent ductus arteriosus. Acta Paediatr Scand 1986; 75 (01) 36-42
- 10 Han UJ, Cho HJ, Cho YK, Choi YY, Ma JS. Change in blood pressure and pulse pressure in preterm infants after treatment of patent ductus arteriosus with indomethacin. Korean Circ J 2011; 41 (04) 203-208
- 11 Meyer S, Sander J, Gräber S, Gottschling S, Gortner L. Agreement of invasive versus non-invasive blood pressure in preterm neonates is not dependent on birth weight or gestational age. J Paediatr Child Health 2010; 46 (05) 249-254