Introduction: Echocardiography (ECHO) with color flow Doppler is considered as the gold standard to identify a hemodynamic patent ductus arteriosus (hs-PDA). However, the optimal diagnostic and therapeutic management for newborns with hs-PDA is still controversial. We aimed to investigate two clinical strategies: (1) targeted treatment based on ECHO criteria and (2) treatment based on ECHO criteria in addition to clinical signs and symptoms. Materials and Methods: This is a cohort study including all neonates consecutively admitted in the Neonatal Intensive Care Unit of University La Sapienza in Rome, with gestational age <32 weeks or body birth weight <1,500 g and with a diagnosis of hs-PDA as confirmed by ECHO evaluation performed within 72 h of life. We classified the babies in two cohorts: (A) pharmacological treatment immediately after ECHO screening and (B) pharmacological therapy for PDA was administered when the relevance of a hs-PDA was associated with clinical signs of hemodynamic instability. Results: We considered as primary outcome newborns who survived without any morbidities (A: 48.1% vs. B: 22.2%, p = 0.022). In particular, we found that the rate of intraventricular hemorrhage stage ≥2 was increased in cohort B (A: 3.7% vs. B 24.4%, p = 0.020). A multivariate analysis showed that assignment to cohort A independently influences the primary outcome. Conclusions: Adopting an hs-PDA management option based on ECHO-directed therapy regardless of symptoms may reduce the morbidity and improve the survival of very low birth weight infants.

Echocardiography-guided management of preterms with patent ductus arteriosus influences the outcome: a cohort study / Terrin, G.; Di Chiara, M.; Boscarino, G.; Versacci, P.; Di Donato, V.; Giancotti, A.; Pacelli, E.; Faccioli, F.; Onesta, E.; Corso, C.; Ticchiarelli, A.; De Curtis, M.. - In: FRONTIERS IN PEDIATRICS. - ISSN 2296-2360. - 8:(2020). [10.3389/fped.2020.582735]

Echocardiography-guided management of preterms with patent ductus arteriosus influences the outcome: a cohort study

Terrin G.
;
Di Chiara M.;Boscarino G.;Versacci P.;Di Donato V.;Giancotti A.;De Curtis M.
2020

Abstract

Introduction: Echocardiography (ECHO) with color flow Doppler is considered as the gold standard to identify a hemodynamic patent ductus arteriosus (hs-PDA). However, the optimal diagnostic and therapeutic management for newborns with hs-PDA is still controversial. We aimed to investigate two clinical strategies: (1) targeted treatment based on ECHO criteria and (2) treatment based on ECHO criteria in addition to clinical signs and symptoms. Materials and Methods: This is a cohort study including all neonates consecutively admitted in the Neonatal Intensive Care Unit of University La Sapienza in Rome, with gestational age <32 weeks or body birth weight <1,500 g and with a diagnosis of hs-PDA as confirmed by ECHO evaluation performed within 72 h of life. We classified the babies in two cohorts: (A) pharmacological treatment immediately after ECHO screening and (B) pharmacological therapy for PDA was administered when the relevance of a hs-PDA was associated with clinical signs of hemodynamic instability. Results: We considered as primary outcome newborns who survived without any morbidities (A: 48.1% vs. B: 22.2%, p = 0.022). In particular, we found that the rate of intraventricular hemorrhage stage ≥2 was increased in cohort B (A: 3.7% vs. B 24.4%, p = 0.020). A multivariate analysis showed that assignment to cohort A independently influences the primary outcome. Conclusions: Adopting an hs-PDA management option based on ECHO-directed therapy regardless of symptoms may reduce the morbidity and improve the survival of very low birth weight infants.
2020
intraventricular hemorrhage (IVH); morbidity; newborn; survival; very low birth weight (VLBW)
01 Pubblicazione su rivista::01a Articolo in rivista
Echocardiography-guided management of preterms with patent ductus arteriosus influences the outcome: a cohort study / Terrin, G.; Di Chiara, M.; Boscarino, G.; Versacci, P.; Di Donato, V.; Giancotti, A.; Pacelli, E.; Faccioli, F.; Onesta, E.; Corso, C.; Ticchiarelli, A.; De Curtis, M.. - In: FRONTIERS IN PEDIATRICS. - ISSN 2296-2360. - 8:(2020). [10.3389/fped.2020.582735]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1481260
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