A Patent Ductus Arteriosus Severity Score Predicts Chronic Lung Disease or Death before Discharge

El-Khuffash, Afif; James, Adam; Corcoran, J D; Dicker, Patrick; Franklin, Orla; Elsayed, Yasser; Ting, Joseph; Sehgal, Arvind; Malikiwi, Andra; Harabor, Andrei; Soraisham, Amuchou; McNamara, Patrick J.

doi:10.1016/j.jpeds.2015.09.028

Cited by 174 publications

(118 citation statements)

References 25 publications

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“…A cut-off PDAsc of 5.0 had an area under the curve of 0.92 (95% CI 0.86 to 0.97, p<0.001) for the ability to predict CLD/death. A PDAsc cut-off of 5 has sensitivity and specificity of 92% and 87%, and positive and negative predictive values of 92% and 82% 26. These data may be used in future trials to define the population at risk and facilitate a randomised trial of PDA treatment based on echocardiography markers of PDA significance.…”

Section: Pda Treatment: Reflections Of the Past 10 Yearsmentioning

confidence: 99%

“…These concerns formed the basis for a prospective observational natural history study to accurately define haemodynamic significance, determine the optimum time of assessment and relate markers of haemodynamic significance to BPD or death before discharge thereby informing future trials of early targeted intervention 26. Serial echocardiography was performed at multiple time points in the 1st week of life in 141 infants under 29 weeks gestation to identify the earliest age and parameters with the best discriminatory ability.…”

Section: Pda Treatment: Reflections Of the Past 10 Yearsmentioning

confidence: 99%

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Reflections of the changes in patent ductus arteriosus management during the last 10 years

El-Khuffash

Weisz

McNamara

2016

Arch Dis Child Fetal Neonatal Ed

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Despite a large body of scientific evidence on the management of premature infants with a patent ductus arteriosus controversy remains and neonatologists remain challenged for knowing which patient to treat, what is the most optimal timing of treatment and which treatments have a positive impact on both short-term and long-term outcomes. In this review article we discuss the increased body of evidence over the past 10 years, much of which questions the role of treatment and suggests the need to reconsider how haemodynamic significance is adjudicated. In addition, we discuss novel approaches to assessment and diagnosis, and highlight areas for future investigation.

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Section: Pda Treatment: Reflections Of the Past 10 Yearsmentioning

confidence: 99%

Section: Pda Treatment: Reflections Of the Past 10 Yearsmentioning

confidence: 99%

Reflections of the changes in patent ductus arteriosus management during the last 10 years

El-Khuffash

Weisz

McNamara

2016

Arch Dis Child Fetal Neonatal Ed

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“…TDI is more sensitive in detecting and monitoring myocardial dysfunction in critically ill preterm infants and term infants with congenital diaphragmatic hernia and neonatal sepsis [35][36][37][38] . TDI may also provide functional haemodynamic data to assist in outcome prediction models [35][36][37][38][39] . TDI is positively influenced by increasing preload, and negatively influenced by increasing afterload [24,31] .…”

Section: Tissue Doppler Velocity Imagingmentioning

confidence: 99%

Novel Echocardiography Methods in the Functional Assessment of the Newborn Heart

et al. 2016

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Echocardiography in the neonatal intensive care unit has led to improvements in our ability to assess the neonatal heart in health and disease. Advances in neonatal cardiac imaging have provided the capability to obtain quantitative information that often supersedes the qualitative information provided by conventional methods. Novel quantitative measures of function include the assessment of the velocity of muscle tissue movement during systole and diastole using tissue Doppler velocity imaging, and evaluation of deformation and rotational characteristics of the myocardium utilizing speckle tracking echocardiography or tissue Doppler-derived strain imaging. A comprehensive understanding of these novel functional modalities, their predictive value, and limitations can greatly assist in managing both the normal and maladaptive responses in the newborn period. This article discusses the novel and emerging methods for assessment of left and right heart function in the neonatal population.

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“…Inconsistency in the diagnosis of hsPDA may obscure the link between a PDA and BPD development. As previously described, the volume of PDA flow is a key factor in determining BPD risk . Assessing PDA flow by echocardiogram, however, is labor‐intensive and requires significant skill.…”

Section: Hemodynamically Significant Pda and Bpdmentioning

confidence: 99%

“…A causative relationship between the PDA and the development of BPD is suggested by evidence that shows there is a dose‐dependent correlation between ductal flow and BPD risk. El‐Khuffash et al derived a PDA score based on echocardiography measurements at 48 hours after birth. Variables include gestational age, PDA size, left ventricular output (a marker of increased pulmonary flow), PDA shunt velocity, and left ventricular a waves.…”

Section: Hemodynamically Significant Pda and Bpdmentioning

confidence: 99%

Hemodynamically significant patent ductus arteriosus and the development of bronchopulmonary dysplasia

Willis

Weems

2018

Congenital Heart Disease

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Patent ductus arteriosus (PDA) is prevalent in premature newborns and has been linked to the development of bronchopulmonary dysplasia (BPD), a serious pulmonary complication of premature birth. Although a causal relationship has not been proven, the link is greatest among infants born at lower gestational age who are treated with mechanical ventilation in the presence of a large ductal shunt. Despite strong association in epidemiological studies, treatment of a patent ductus arteriosus has not been shown to prevent BPD, and some therapies may increase the risk of BPD. We describe preclinical and clinical data demonstrating the association of a PDA with BPD, highlight the effects of surgical and pharmacological treatment, and explore the implications of recent clinical trials for the management of PDA in the premature newborn.

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A Patent Ductus Arteriosus Severity Score Predicts Chronic Lung Disease or Death before Discharge

Cited by 174 publications

References 25 publications

Reflections of the changes in patent ductus arteriosus management during the last 10 years

Reflections of the changes in patent ductus arteriosus management during the last 10 years

Novel Echocardiography Methods in the Functional Assessment of the Newborn Heart

Hemodynamically significant patent ductus arteriosus and the development of bronchopulmonary dysplasia

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