Development of a Diagnostic Clinical Score for Hemodynamically Significant Patent Ductus Arteriosus

• Main Authors: Annemarie Kindler (Author), Barbara Seipolt (Author), Antje Heilmann (Author), Ursula Range (Author), Mario Rüdiger (Author), Sigrun Ruth Hofmann (Author)
• Format: Book
• Published: Frontiers Media S.A., 2017-12-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

There is no consensus about the hemodynamic significance and, therefore, the need to treat a persistent ductus arteriosus in preterm newborns. Since the diagnosis of a hemodynamically significant persistent ductus arteriosus (hsPDA) is made by a summary of non-uniform echo-criteria in combination with the clinical deterioration of the preterm neonate, standardized clinical and ultrasound scoring systems are needed. The objective of this study was the development of a clinical score for the detection and follow-up of hsPDA. In this observational cohort study of 154 preterm neonates (mean gestational age 28.1 weeks), clinical signs for the development of hsPDA were recorded in a standardized score and compared to echocardiography. Analyzing the significance of single score parameters compared to the diagnosis by echocardiography, we developed a short clinical score (calculated sensitivity 84% and specificity 80%). In conclusion, this clinical diagnostic PDA score is non-invasive and quickly to implement. The continuous assessment of defined clinical parameters allows for a more precise diagnosis of hemodynamic significance of PDA and, therefore, should help to detect preterm neonates needing PDA-treatment. The score, therefore, allows a more targeted use of echocardiography in these very fragile preterm neonates.

Item Description

2296-2360
10.3389/fped.2017.00280