Echocardiographic predictors of symptomatic patent ductus arteriosus in extremely-low-birth-weight preterm neonates

Objective:identify echocardiographic parameters at ⩽4 day postnatal that predict the subsequent need for closure of a clinically significant patent ductus arteriosus (spda) in extremely-low-birth-weight neonates (elbw).study design:serial echocardiograms obtained in 115 elbw at ⩽10 day postnatal were examined to estimate pda size using the pda:left pulmonary artery (lpa) diameter ratio: ⩾1 indicated a large pda, <1 but ⩾0.5 moderate, and <0.5 small. sensitivity, specificity, and positive predictive values (ppv) were determined for elbw <27 weeks and ⩾27 weeks gestational age.result:neonates with moderate to large pda at ⩽4 day had 15-times greater likelihood of requiring treatment for spda than those with a small pda (95% confidence interval (ci): 5.6–41). sensitivity, specificity and ppv of the pda:lpa at <27 weeks was 80, 86 and 92%, respectively.conclusion:a moderate to large pda determined from the pda:lpa ratio at ⩽4 day postnatal identifies neonates <27 week gestation who subsequently require closure of a pda.