PEDIATRICS Vol. 71 No. 3 March 1983, pp. 364-372
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Evaluation of the Preterm Infant for Patent Ductus Arteriosus

R. Curtis Ellison MD1, George J. Peckham MD1, Peter Lang MD1, Norman S. Talner MD1, Trudy J. Lerer MS1, Lillian Lin MS1, Kenneth J. Dooley MD1, and Alexander S. Nadas MD1

1 From the National Collaborative Study on Patent Ductus Arteriosus in Premature Infants

As a first step in a multicenter, collaborative project to study the role of indomethacin in the management of patent ductus arteriosus in premature infants, a diagnostic scheme was developed, on an a priori basis, by a consensus of the participating neonatologists and pediatric cardiologists. The scheme, which utilizes clinical and noninvasive findings, was designed to detect infants with a "hemodynamically significant" patent ductus arteriosus (PDA). Among 1,689 infants with birth weight less than 1,750 g who were monitored during the first year of the study, 342 (20.2%) met the criteria for PDA. Rates were higher for smaller infants (42% with birth weight <1,000 g) than for larger infants (7% with birth weight 1,500 to 1,750 g). Although study protocol did not require a direct procedure to confirm the diagnosis of PDA, a marked decrease in the presence of most criteria was noted following surgical ligation of the ductus. Although the echocardiographic criterion (ratio of left atrium to aorta [LA/Ao]ge1.15) proved to have a low specificity for PDA, the data suggest that the overall scheme led to a very low rate of false-positive diagnosis. Following the application of the scheme for 1 year at 13 clinical centers, it has been shown to be a highly acceptable means of detecting infants with PDA.

Key Words: patent ductus arteriosus • preterm infants • diagnostic scheme

Submitted on February 16, 1982
Accepted on June 16, 1982




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