208 Accuracy in Pda Diagnosis: The Hemodynamic Significance and Early Treatment in Preterm Infants Less Than 32 Weeks Gestation

Abstract

Background: Despite the high rate of spontaneous closure among premature infants, early treatment should be considered, in particular if respiratory support is demanded. An early and accurate echocardiographic diagnosis of significant ductal shunt is performed. A ductal diameter assessed by color Doppler greater than 1.5 mm generally indicates a significant shunt.

Aims: To compare the differences between the infants with spontaneous closure of PDA and the infants who received treatment.

Methods: From 2005 to 2009 all ≤32GA infants had a daily echocardiographic study done. We used pediatric ibuprofen intravenous formulation, according to recommended dosage. In case of failure of closure or re-opening, a second course of 3 doses may be given, after which surgery is indicated.

Results: 325 neonates were eligible. Non significant PDA occurred in 250(77%) neonates(G1), while 75(23%) needed treatment(G2) following our NICU standard protocol

Table 1

Table 1 ?emptypara?

Conclusions: Accurate and early diagnosis of PDA seems to be necessary and the diameter of the duct > 1.5mm is a significant echocardiographic parameter indicating infants to be treated. Only 23% needed a pharmacological treatment for a significant PDA, while 99% of not treated-neonates had the duct spontaneously closed at discharge. Treated infants had a significantly lower gestational age, higher CRIB score and needed more ventilation support. Multivariate analysis underlined gestational age is the first factor correlated to the treatment of PDA.

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