Diagnostic value of clinical criteria in the diagnosis of hemodynamically significant patent ductus arteriosus in the preterm infants on their third day of life

Abstract

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.