Yıl 2020, Cilt 17 , Sayı 2, Sayfalar 342 - 344 2020-06-25

Diagnostic value of clinical criteria in the diagnosis of hemodynamically significant patent ductus arteriosus in the preterm infants on their third day of life
Yaşamın üçüncü gününde preterm bebeklerde hemodinamik olarak anlamlı patent duktus arteriozusun tanısında klinik bulguların önemi

Ozkan İLHAN [1] , Senem ALKAN ÖZDEMİR [2] , Sinem AKBAY [3] , Ali Rahmi BAKİLER [4] , Berat KANAR [5] , Şeyma MEMUR [6] , Meltem BOR [7] , Esra ÖZER [8]


Aim: The purpose of this study is to compare the clinical criteria of preterm infants on their third day of life with their echocardiographic findings for the correct diagnosis of hemodynamically significant patent ductus arteriosus (hsPDA). Material And Methods:The infants with a gestational age of <31 weeks and with a birth weight of <1250 g who underwent echocardiography on their third day of life were included in this retrospective study. The primary motive of this study is to identify whether clinical findings are feasible in the prediction of hsPDA. Results: Of the 47 preterm infants, 29 had hsPDA (the hsPDA group) and 18 did not had patent ductus arteriosus (the control group). This observation was made by an echocardiographic examination. The rate of tachypnea and increased oxygen requirement were statistically significantly higher in the hsPDA group than in the control group (p = 0.01 and p = 0.004, respectively). The incidence of tachycardia and hypotension was statistically significantly higher in the hsPDA group than in the control group (p = 0.03 and p = 0.004, respectively). The rate of metabolic acidosis was significantly higher in the hsPDA group than in the control group (p = 0.005). There were no significant differences in murmur, hyperdynamic precordium, and widened pulse pressure between the groups. The incidence rates of tachycardia, hypotension, and metabolic acidosis were statistically significantly higher in the hsPDA group even when the rates of tachypnea increased the oxygen requirement. Thelogistic regression demonstrated that the metabolic acidosis was the only significant predictor of hsPDA [OR: 7.10 (p = 0.02, 95% CI: 1.34–37.53)]. Conclusion: Metabolic acidosis is the most reliable clinical finding for the prediction of hsPDA in the preterm infants on the third day of life.
Amaç: Bu çalışmanın amacı preterm bebeklerde yaşamın üçüncü gününde hemodinamik olarak anlamlı patent duktus arteriozusun (PDA) tanısında ekokardiyografik bulgularla klinik bulguları karşılaştırmaktır. Gereç ve Yöntemler: Bu retrospektif çalışmaya 31. gestasyonel hafta ve 1250 gramın altında doğan, yaşamın üçüncü gününde ekokardiyografi yapılan 47 preterm bebek alındı. Klinik bulguların hemodinamik olarak anlamlı PDA’yı öngörüp öngörememesi primer sonuç olarak belirlendi. Bulgular: Çalışmaya alınan 47 preterm bebeğin ekokardiyografik olarak 29’unda hemodinamik olarak anlamlı PDA (hemodinamik olarak anlamlı PDA grubu) tespit edilirken, 18’inde PDA tespit edilmedi (kontrol grubu). Takipne ve artmış oksijen ihtiyacı oranı hemodinamik olarak anlamlı PDA grubunda kontrol grubuna göre anlamlı olarak daha yüksekti (sırasıyla, p = 0.01 ve p = 0.004). Taşikardi, hipotansiyon ve metabolik asidoz oranı hemodinamik olarak anlamlı PDA grubunda anlamlı olarak daha yüksekti (sırasıyla, p = 0.03, p = 0.004 ve p = 0.005). Üfürüm, hiperdinamik prekordiyum ve genişlemiş nabız basıncı açısından gruplar arasında anlamlı fark saptanmadı. Takipne, artmış oksijen ihtiyacı, taşikardi ve hipotansiyon oranı hemodinamik olarak anlamlı PDA grubunda anlamlı olarak daha yüksek olsa da, lojistik regresyon analizinde sadece metabolik asidozun hemodinamik olarak anlamlı PDA’yı öngörebileceği gösterildi [OR:7.10 (p = 0.02, 95% CI: 1.34-37.53)]. Sonuç: Metabolik asidoz, preterm bebeklerde yaşamın üçüncü gününde hemodinamik olarak anlamlı PDA’yı öngörmede en güvenilir klinik bulgudur.
  • Van Overmeire B, Chemtob S. The pharmacologic closure of the patent ductus arteriosus. Semin Fetal Neonatal Med 2005;10:177-84.
  • Costeloe K, Hennessy E, Gibson AT, Marlow N, Wilkinson AR.The EPICure study: outcomes to discharge from hospital for infants born at the threshold of viability.Pediatrics 2000;106:659-71.
  • Chiruvolu A, Punjwani P, Ramaciotti C. Clinical and echocardiographic diagnosis of patent ductus arteriosus in premature neonates.Early Hum Dev 2009;85:147-9.
  • Benitz WE, Commıttee on Fetus and Newborn, American Academy of Pediatrics. Patent Ductus Arteriosus in Preterm Infants. Pediatrics 2016;137:e20153730.
  • Behrman RE, RM Kliegman, HB Jensen (eds): Nelson Textbook of Pediatrics. 17th edition. Saunders, Philadelphia 2004;579.
  • Hamrick SE, Hansmann G. Patent ductus arteriosus of the preterm infant. Pediatrics 2010;125:1020-30.
  • El Hajjar M, Vaksmann G, Razka T, Kongolo G, Storme L. Severity of the ductal shunt: a comparison of different markers. Arch Dis Child Fetal Neonatal Ed 2005;90:419–22.
  • Skinner J. Diagnosis of patent ductus arteriosus. Semin Neonatol 2001;6:49–61.
  • Zonnenberg I , de Waal K. The definition of a haemodynamic significant duct in randomized controlled trials: a systematic literature review. Acta Paediatr 2012;101:247-51.
  • Papile LA, Burstein J, Burstein R, Koffler H. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm. J Pediatr 1978;92:529–34.
  • Bell MJ. Neonatal necrotizing enterocolitis. N Engl J Med 1978;298:281-2.
  • Jobe AH, Bancalari E. Bronchopulmonary dysplasia. Am J Respir Crit Care Med 2001;163:1723-9.
  • International Committee for the Classification of retinopathy of prematurity. The international classification of retinopathy of prematurity revisited. Arch Ophthalmol 2005;123:991-9.
  • Snider AR, Serwer GA, Ritter SB. Echocardiography in pediatric heart disease. Second ed. Mosby Inc 1997;452-8.
  • Clyman RI.The role of patent ductus arteriosus and its treatments in the development of bronchopulmonary dysplasia. Semin perinatol 2013;37:102-7.
  • Pourarian S, Sharma D, Farahbakhsh N, Cheriki S, Bijanzadeh F. To evaluate the prevalence of symptomatic and non-symptomatic ductus arteriosus and accuracy of physical signs in diagnosing PDA in preterm infants using blinded comparison of clinical and echocardiographic findings during the first week of life: a prospective observational study from Iran. J Matern Fetal Neonatal Med 2017;30:1666-70.
  • McNamara PJ, Sehgal A. Towards rational management of the patent ductus arteriosus: the need for disease staging. Arch Dis Child Fetal Neonatal Ed 2007;92:424-7.
  • Skelton R, Evans N, Smythe J.A blinded comparison of clinical and echocardiographic evaluation of the preterm infant for patent ductus arteriosus. J Paediatr Child Health 1994;30:406-11.
  • Sasi A, Deorari A.Patent ductus arteriosus in preterm infants. Indian Pediatr 2011; 48:301-8.
  • Evans N, Moor Craft J. Effect of patency of the ductus arteriosus on blood pressure in very preterm infants. Arch Dis Child 1992;67:1169-73.
  • Han UJ, Cho HJ, Cho YK, Choi YY, Ma JS. Change in blood pressure and pulse pressure in preterm infants after treatment of patent ductus arteriosus with indomethacin. Korean Circ J 2011;41:203-8.
  • Tammela O, Ojala R, Iivainen T, et al. Short versus prolonged indomethacin therapy for patent ductus arteriosus in preterm infants. J Pediatr 1999;134:552-7.
  • Engur D, Deveci M, Turkmen MK. Early signs that predict later haemodynamically significant patent ductus arteriosus. Cardiol Young 2016;26:439-45.
  • Alagarsamy S, Chhabra M, Gudavalli M, Nadroo AM, Sutija VG, Yugrakh D. Comparison of clinical criteria with echocardiographic findings in diagnosing PDA in preterm infants. J Perinat Med 2005;33:161-4.
  • Davis P, S Turner-Gomes, K Cunningham, C Way, R Roberts, B Schmid. Precision and accuracy of clinical and radiological signs in premature infants at risk of patent ductus arteriosus. Arch Pediatr Adolesc Med 1995;149:1136-41.
  • Vitali F, Galletti S, Aceti A, et al. Pilot observational study on haemodynamic changes after surfactant administration in preterm newborns with respiratory distress syndrome. Ital J Pediatr 2014;40:26.
  • Hamdan AH, Shaw NJ. Changes in pulmonary artery pressure during the acute phase of respiratory distress syndrome treated with three different types of surfactant. Pediatr Pulmonol 1998;25:191-5
  • Kumar a, Lakkundi A, McNamara PJ, Sehgal A. Surfactant and patent ductus arteriosus. Indian J Pediatr 2010;77:51-5.
  • Sehgal A, Mak W, Dunn M, et al. Haemodynamic changes after delivery room surfactant administration to very low birth weight infants. Arch Dis Child Fetal Neonatal Ed 2010;95:F345-51.
Birincil Dil en
Konular Pediatri
Bölüm Araştırma Makaleleri
Yazarlar

Orcid: 0000-0002-6124-9796
Yazar: Ozkan İLHAN (Sorumlu Yazar)
Kurum: Department of Neonatology, Tepecik Training and Research Hospital, Izmir, Turkey.
Ülke: Turkey


Orcid: 0000-0003-0474-7120
Yazar: Senem ALKAN ÖZDEMİR
Kurum: Department of Neonatology, Dr. Behcet Uz Children’s Hospital, Izmir, Turkey.
Ülke: Turkey


Orcid: 0000-0003-1266-320X
Yazar: Sinem AKBAY
Kurum: Department of Neonatology, Tepecik Training and Research Hospital, Izmir, Turkey.
Ülke: Turkey


Orcid: 0000-0001-8234-3071
Yazar: Ali Rahmi BAKİLER
Kurum: Department of Pediatric Cardiology, Tepecik Training and Research Hospital, Izmir, Turkey
Ülke: Turkey


Orcid: 0000-0001-7886-8932
Yazar: Berat KANAR
Kurum: Department of Neonatology, Tepecik Training and Research Hospital, Izmir, Turkey
Ülke: Turkey


Orcid: 0000-0001-6099-7496
Yazar: Şeyma MEMUR
Kurum: Department of Neonatology, Tepecik Training and Research Hospital, Izmir, Turkey
Ülke: Turkey


Orcid: 0000-0002-4171-2149
Yazar: Meltem BOR
Kurum: Harran University School of Medicine, Department of Neonatology, Sanliurfa, Turkey
Ülke: Turkey


Orcid: 0000-0003-2634-7136
Yazar: Esra ÖZER
Kurum: Department of Neonatology, Tepecik Training and Research Hospital, Izmir, Turkey
Ülke: Turkey


Tarihler

Başvuru Tarihi : 12 Ocak 2020
Kabul Tarihi : 24 Şubat 2020
Yayımlanma Tarihi : 25 Haziran 2020

Bibtex @araştırma makalesi { jgon673678, journal = {Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi}, issn = {}, eissn = {2667-7849}, address = {Talatpaşa Bulvarı No 128, Hamamönü - ANKARA}, publisher = {T.C. Sağlık Bakanlığı Ankara Şehir Hastanesi}, year = {2020}, volume = {17}, pages = {342 - 344}, doi = {10.38136/jgon.673678}, title = {Diagnostic value of clinical criteria in the diagnosis of hemodynamically significant patent ductus arteriosus in the preterm infants on their third day of life}, key = {cite}, author = {İlhan, Ozkan and Alkan Özdemi̇r, Senem and Akbay, Sinem and Baki̇ler, Ali and Kanar, Berat and Memur, Şeyma and Bor, Meltem and Özer, Esra} }
APA İlhan, O , Alkan Özdemi̇r, S , Akbay, S , Baki̇ler, A , Kanar, B , Memur, Ş , Bor, M , Özer, E . (2020). Diagnostic value of clinical criteria in the diagnosis of hemodynamically significant patent ductus arteriosus in the preterm infants on their third day of life. Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi , 17 (2) , 342-344 . DOI: 10.38136/jgon.673678
MLA İlhan, O , Alkan Özdemi̇r, S , Akbay, S , Baki̇ler, A , Kanar, B , Memur, Ş , Bor, M , Özer, E . "Diagnostic value of clinical criteria in the diagnosis of hemodynamically significant patent ductus arteriosus in the preterm infants on their third day of life". Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi 17 (2020 ): 342-344 <https://dergipark.org.tr/tr/pub/jgon/issue/55298/673678>
Chicago İlhan, O , Alkan Özdemi̇r, S , Akbay, S , Baki̇ler, A , Kanar, B , Memur, Ş , Bor, M , Özer, E . "Diagnostic value of clinical criteria in the diagnosis of hemodynamically significant patent ductus arteriosus in the preterm infants on their third day of life". Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi 17 (2020 ): 342-344
RIS TY - JOUR T1 - Diagnostic value of clinical criteria in the diagnosis of hemodynamically significant patent ductus arteriosus in the preterm infants on their third day of life AU - Ozkan İlhan , Senem Alkan Özdemi̇r , Sinem Akbay , Ali Baki̇ler , Berat Kanar , Şeyma Memur , Meltem Bor , Esra Özer Y1 - 2020 PY - 2020 N1 - doi: 10.38136/jgon.673678 DO - 10.38136/jgon.673678 T2 - Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi JF - Journal JO - JOR SP - 342 EP - 344 VL - 17 IS - 2 SN - -2667-7849 M3 - doi: 10.38136/jgon.673678 UR - https://doi.org/10.38136/jgon.673678 Y2 - 2020 ER -
EndNote %0 Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi Diagnostic value of clinical criteria in the diagnosis of hemodynamically significant patent ductus arteriosus in the preterm infants on their third day of life %A Ozkan İlhan , Senem Alkan Özdemi̇r , Sinem Akbay , Ali Baki̇ler , Berat Kanar , Şeyma Memur , Meltem Bor , Esra Özer %T Diagnostic value of clinical criteria in the diagnosis of hemodynamically significant patent ductus arteriosus in the preterm infants on their third day of life %D 2020 %J Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi %P -2667-7849 %V 17 %N 2 %R doi: 10.38136/jgon.673678 %U 10.38136/jgon.673678
ISNAD İlhan, Ozkan , Alkan Özdemi̇r, Senem , Akbay, Sinem , Baki̇ler, Ali , Kanar, Berat , Memur, Şeyma , Bor, Meltem , Özer, Esra . "Diagnostic value of clinical criteria in the diagnosis of hemodynamically significant patent ductus arteriosus in the preterm infants on their third day of life". Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi 17 / 2 (Haziran 2020): 342-344 . https://doi.org/10.38136/jgon.673678
AMA İlhan O , Alkan Özdemi̇r S , Akbay S , Baki̇ler A , Kanar B , Memur Ş , Bor M , Özer E . Diagnostic value of clinical criteria in the diagnosis of hemodynamically significant patent ductus arteriosus in the preterm infants on their third day of life. JGON. 2020; 17(2): 342-344.
Vancouver İlhan O , Alkan Özdemi̇r S , Akbay S , Baki̇ler A , Kanar B , Memur Ş , Bor M , Özer E . Diagnostic value of clinical criteria in the diagnosis of hemodynamically significant patent ductus arteriosus in the preterm infants on their third day of life. Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi. 2020; 17(2): 344-342.