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

• मुख्य लेखकों: Annemarie Kindler (लेखक), Barbara Seipolt (लेखक), Antje Heilmann (लेखक), Ursula Range (लेखक), Mario Rüdiger (लेखक), Sigrun Ruth Hofmann (लेखक)
• स्वरूप: पुस्तक
• प्रकाशित: Frontiers Media S.A., 2017-12-01T00:00:00Z.
• विषय: article
• ऑनलाइन पहुंच: Connect to this object online.
• Notes: 2296-2360; 10.3389/fped.2017.00280
• Keywords: arterial duct; clinical diagnostic score; echocardiography; ductus arteriosus Botalli; premature infants; very low birth weight; Pediatrics; RJ1-570
• Source: Frontiers in Pediatrics, Vol 5 (2017)

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.