Echocardiography as a guide for patent ductus arteriosus ibuprofen treatment and efficacy prediction.
Pediatr Crit Care Med
; 13(3): 324-7, 2012 May.
Article
em En
| MEDLINE
| ID: mdl-21760564
ABSTRACT
OBJECTIVE:
To evaluate echocardiography criteria in predicting the response to ibuprofen treatment.DESIGN:
A prospective cohort study of preterm infants untreated or treated with ibuprofen for patent ductus arteriosus.SETTING:
Three academic neonatal intensive care units. PATIENTS Two hundred fifty-two preterm infants of 27-31 wks gestation.INTERVENTIONS:
Ibuprofen treatment within the first 5 days of life was indicated when at least two out of four conventional echocardiography criteria were observed ductal diameter >2 mm, left-right ductal shunt maximum velocity <2 m/sec, mean flow velocity in left pulmonary artery >0.4 m/sec, and end-diastolic flow velocity in left pulmonary artery >0.2 m/sec. MEASUREMENTS AND MAINRESULTS:
Of the infants analyzed, 135 had a closed ductus at an average age of 1.9 ± 0.9 days, and 43 had an open ductus but <2 predefined criteria. Seventy-four infants (29%) received ibuprofen on day 2.2 ± 1.1. Sixteen infants failed ibuprofen and nine had to undergo surgical ligation. The left-right ductal shunt maximum velocity criterion had the best negative predictive value for treatment response, while the ductal diameter criterion had the best positive predictive value.CONCLUSIONS:
Echocardiography may be a useful tool to help patent ductus arteriosus management. A combined use of ductal diameter and left-right ductal shunt maximum velocity criteria allows a more accurate prediction of the response of infants with patent ductus arteriosus to ibuprofen treatment.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Anti-Inflamatórios não Esteroides
/
Ibuprofeno
/
Ecocardiografia Doppler de Pulso
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Ecocardiografia Doppler em Cores
/
Permeabilidade do Canal Arterial
/
Doenças do Prematuro
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
/
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
/
Newborn
Idioma:
En
Revista:
Pediatr Crit Care Med
Assunto da revista:
PEDIATRIA
/
TERAPIA INTENSIVA
Ano de publicação:
2012
Tipo de documento:
Article
País de afiliação:
França