Effects of Patent Ductus Arteriosus on Organ Blood Flow in Infants Born Very Preterm: A Prospective Study with Serial Echocardiography.
J Pediatr
; 216: 95-100.e2, 2020 01.
Article
em En
| MEDLINE
| ID: mdl-31610928
ABSTRACT
OBJECTIVE:
To characterize the effects of a patent ductus arteriosus (PDA) on different organ blood flows in infants born preterm. STUDYDESIGN:
Infants born preterm at ≤30 weeks of gestational age had daily echocardiography and Doppler assessments of middle cerebral artery, celiac artery, superior mesenteric (SMA), and renal arteries (RA) during the first postnatal week. Abnormal organ blood flow was defined as either reverse or absent diastolic flow, abnormally low mean or systolic velocities, or abnormally high pulsatility or resistance index.RESULTS:
Twenty-five infants born very preterm (gestational age 27.0 ± 2.1 weeks) were enrolled. PDA presence at time of measurement increased the risk of abnormal organ blood flows (39% vs 8%, P < .001). Ductal diameter and left atrium-to-aortic root (LA/Ao) ratio correlated positively with resistance index (celiac artery, SMA, RA), and negatively with mean velocity (ductal diameter SMA, RA; LA/Ao ratio RA). A PDA >2.0 mm, LA/Ao ratio >1.4, and their combination were associated with 8.0 (95% CI 1.6-39.4)-, 6.7 (1.3-34.7)-, and 38.2 (3.2-455.5)-fold increase in risk of abnormal organ blood flow index, respectively. Abnormal descending aorta flow was detected in only 2% of measurements.CONCLUSIONS:
Ductal size >2.0 mm and LA/Ao >1.4, especially in combination, are associated with a greater risk of abnormal organ blood flows. We suggest that Doppler assessment of the renal and superior mesenteric arteries are more likely to detect systemic hypoperfusion than the descending aorta.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Velocidade do Fluxo Sanguíneo
/
Débito Cardíaco
/
Permeabilidade do Canal Arterial
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Female
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Humans
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Male
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Newborn
Idioma:
En
Revista:
J Pediatr
Ano de publicação:
2020
Tipo de documento:
Article