Skip to main content

Can a clinical decision rule help ductus arteriosus management in preterm neonates?

Buy Article:

$43.00 plus tax (Refund Policy)

Abstract

Aim:  Patent ductus arteriosus (DA) occurs frequently in premature neonates with respiratory distress syndrome. We assessed a combination of clinical, biological and echocardiographic parameters to derive a decision rule for selecting candidates for treatment based on the criteria in use in our unit.

Methods:  Hundred and forty neonates with a mean (SD) gestational age of 28 (2.3) weeks and a mean birth weight of 1159 (386) g, all requiring invasive ventilation with FiO2 > 0.3 or catecholamines for severe hypotension, were assessed prospectively using echocardiography in conjunction with N‐terminal pro‐B‐type natriuretic peptide (NTpBNP) levels within 24–72 h of birth. Independent predictors of DA treatment were identified with univariate analysis and combined in a clinical decision rule.

Results:  Early treatment of significant DA was adopted for 26 (18.6%) neonates. A clinical decision rule suggesting treatment in patients with NTpBNP > 8500 pg/mL, ductal diameter >1.5 mm and, for infants with a birth weight >830 g, left pulmonary artery end‐diastolic velocity >0.20 m/sec showed 88% sensitivity and 94% specificity.

Conclusions:  A decision rule using realistic and/or commonly used parameters for significant patent ductus arteriosus assessment could be derived. External validation of this rule is needed before any application.
No References
No Citations
No Supplementary Data
No Article Media
No Metrics

Document Type: Research Article

Affiliations: 1: .Neonatology Department, Arnaud de Villeneuve Hospital, CHU Montpellier, France 2: .Department of Biochemistry, Lapeyronie Hospital, CHU Montpellier, France

Publication date: 2012-05-01

  • Access Key
  • Free content
  • Partial Free content
  • New content
  • Open access content
  • Partial Open access content
  • Subscribed content
  • Partial Subscribed content
  • Free trial content
Cookie Policy
X
Cookie Policy
Ingenta Connect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more