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Tytuł pozycji:

Effects of Patent Ductus Arteriosus on Organ Blood Flow in Infants Born Very Preterm: A Prospective Study with Serial Echocardiography.

Tytuł :
Effects of Patent Ductus Arteriosus on Organ Blood Flow in Infants Born Very Preterm: A Prospective Study with Serial Echocardiography.
Autorzy :
Hsu KH; Fetal and Neonatal Institute, Division of Neonatology, Children's Hospital Los Angeles, Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA; Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital Linkou Branch, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Science, Chang Gung University, Taoyuan, Taiwan.
Nguyen J; Division of Neonatology, Cedar-Sinai Medical Center, Los Angeles, CA; Division of Neonatology, Department of Pediatrics, LAC+USC Medical Center, Keck School of Medicine, University of Southern California, Los Angeles, CA.
Dekom S; Division of Neonatology, Department of Pediatrics, LAC+USC Medical Center, Keck School of Medicine, University of Southern California, Los Angeles, CA.
Ramanathan R; Division of Neonatology, Department of Pediatrics, LAC+USC Medical Center, Keck School of Medicine, University of Southern California, Los Angeles, CA.
Noori S; Fetal and Neonatal Institute, Division of Neonatology, Children's Hospital Los Angeles, Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA. Electronic address: .
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Źródło :
The Journal of pediatrics [J Pediatr] 2020 Jan; Vol. 216, pp. 95-100.e2. Date of Electronic Publication: 2019 Oct 11.
Typ publikacji :
Journal Article
Język :
English
Journal Info :
Publisher: Mosby Country of Publication: United States NLM ID: 0375410 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-6833 (Electronic) Linking ISSN: 00223476 NLM ISO Abbreviation: J. Pediatr. Subsets: Core Clinical (AIM); MEDLINE
Imprint Name(s) :
Original Publication: St. Louis, MO : Mosby
MeSH Terms :
Blood Flow Velocity*
Cardiac Output*
Ductus Arteriosus, Patent/*physiopathology
Ductus Arteriosus, Patent/complications ; Echocardiography ; Female ; Gestational Age ; Humans ; Infant, Extremely Premature ; Infant, Newborn ; Male ; Prospective Studies
Contributed Indexing :
Keywords: hemodynamic significance*; hypoperfusion*
Entry Date(s) :
Date Created: 20191016 Date Completed: 20200611 Latest Revision: 20200611
Update Code :
20200716
DOI :
10.1016/j.jpeds.2019.08.057
PMID :
31610928
Czasopismo naukowe
Objective: To characterize the effects of a patent ductus arteriosus (PDA) on different organ blood flows in infants born preterm.
Study Design: 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.
(Copyright © 2019 Elsevier Inc. All rights reserved.)

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