Abstract
Previously, we found evidence that radial artery pressure wave forms in neonates resemble aortic pressure wave forms in adults. Therefore, it can be expected that the contour of the radial artery wave in infants provides information on central hemodynamics, such as existence of PDA. Using a high-fidelity catheter-manometer system (natural freq. 95 Hz, damping coefficient 0.15), we studied radial artery pressure wave forms in 24 critically ill neonates who suffered from PDA with left-to-right shunt (birthweight 1780 ± 880 gm, gestational age 31.3 ± 3.9 w). 23 infants showed a bisferiens systolic pressure wave. In 14 of them, pressure was measured again after ductal closure (as confirmed echocardiographically): bisferiens pressure peaks had disappeared in 13 of 14 infants. The figure below shows a representative radial artery wave (in mmHg) during PDA (left) and after ductal closure (right). In sum, we found evidence that bisferiens pressure peaks in the radial artery wave are a sign of PDA. Further research is recommended to establish the mechanism and the diagnostic value.
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