• Challenging iisues in diagnosis and management of hemodynamically significant patent ductus arteriosus in preterm infants
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Challenging iisues in diagnosis and management of hemodynamically significant patent ductus arteriosus in preterm infants

SOVREMENNAYA PEDIATRIYA.2016.8(80):22-25; doi 10.15574/SP.2016.80.22 

Challenging iisues in diagnosis and management of hemodynamically significant patent ductus arteriosus in preterm infants


Boichenko A. D.

Kharkiv National Medical University, Ukraine


The purpose of the study is to improve the diagnostic accuracy in identification of hemodynamically significant patent ductus arteriosus in premature infants with extremely low birth weight by Doppler echocardiography and objective clinical criteria and specification of management of such patients in the neonatal period.


Patients and methods. The study involved examination of 125 infants at the gestational age of 24–37 weeks. Doppler echocardiography with identification of central hemodynamics indices and diastolic ventricular function assessment was carried out to all the newborns immediately after birth or within 48 hours after birth.


Results. According to Doppler echocardiography findings preterm infants with hemodynamically significant patent ductus arteriosus were found to have dilation of the left ventricle with hypertrophy of the wall and ventricular septum in 75.9% (p<0.05), dilation of the right ventricular cavity in 82.8% (p<0.05), dilation of the left atrium in 100% (p<0.05), 1st-2nd degree tricuspid and pulmonic regurgitation in 65.5% (p<0.05), increased mean pressure in the left aortic trunk in 79.3% (p<0.05). The study showed that 100% (p<0.05) of children with hemodynamically significant patent ductus arteriosus had ventricular diastolic dysfunction in the form of delayed relaxation. Early complications of hemodynamically significant patent ductus arteriosus included increased respiratory distress in 8 (50%) preterm infants and dependence on supplemental oxygen, 1st-2nd degree intraventricular hemorrhage in 8 (50%), hemorrhagic discharge from the tracheobronchial tree in 5 (31.3%), poor uptake of enteral nutrition in 10 (62.5%, p<0.05), and unstable arterial oxygen saturation in 8 (50%) patients.


Conclusion. Morphological changes of the heart chambers and clinical deterioration of the state in newborn indicates the need to correct hemodynamically significant patent ductus arteriosus surgically.


Key words: preterm infants, hemodynamically significant patent ductus arteriosus, neonatal period.


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