Application of NPE in the assessment of a patent ductus arteriosus

David van Laere; Patrick J McNamara; Bart van Overmeire; Samir Gupta; Afif El-Khuffash; Marilena Savoia; Christoph E Schwarz; Willem P de Boode; European Special Interest Group ‘Neonatologist Performed Echocardiography’ (NPE)

doi:10.1038/s41390-018-0077-x

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Application of NPE in the assessment of a patent ductus arteriosus

Journal article

Open access

Peer reviewed

Application of NPE in the assessment of a patent ductus arteriosus

David van Laere, Patrick J McNamara, Bart van Overmeire, Samir Gupta, Afif El-Khuffash, Marilena Savoia, Christoph E Schwarz, Willem P de Boode and European Special Interest Group ‘Neonatologist Performed Echocardiography’ (NPE)

Pediatric research, Vol.84(Suppl 1), pp.46-56

07/2018

DOI: 10.1038/s41390-018-0077-x

PMCID: PMC6257219

PMID: 30072803

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Abstract

In many preterm infants, the ductus arteriosus remains patent beyond the first few days of life. This prolonged patency is associated with numerous adverse outcomes, but the extent to which these adverse outcomes are attributable to the hemodynamic consequences of ductal patency, if at all, has not been established. Different treatment strategies have failed to improve short-term outcomes, with a paucity of data on the correct diagnostic and pathophysiological assessment of the patent ductus arteriosus (PDA) in association with long-term outcomes. Echocardiography is the selected method of choice for detecting a PDA, assessing the impact on the preterm circulation and monitoring treatment response. PDA in a preterm infant can result in pulmonary overcirculation and systemic hypoperfusion, Therefore, echocardiographic assessment should include evaluation of PDA characteristics, indices of pulmonary overcirculation with left heart loading conditions, and indices of systemic hypoperfusion. In this review, we provide an evidence-based overview of the current and emerging ultrasound measurements available to identify and monitor a PDA in the preterm infant. We offer indications and limitations for using Neonatologist Performed Echocardiography to optimize the management of a neonate with a PDA.

Phenotype

Cardiomyopathies - diagnostic imaging

Ductus Arteriosus - physiopathology

Prognosis

Infant, Premature, Diseases

Neonatology - methods

Persistent Fetal Circulation Syndrome - diagnostic imaging

Humans

Echocardiography - methods

Ductus Arteriosus - diagnostic imaging

Risk

Hemodynamics - physiology

Arrhythmias, Cardiac - diagnostic imaging

Infant, Newborn, Diseases - diagnostic imaging

Infant, Premature

Myocarditis - diagnostic imaging

Neonatologists

Ductus Arteriosus, Patent - physiopathology

Ductus Arteriosus, Patent - diagnostic imaging

Infant, Newborn

Details

Title: Subtitle: Application of NPE in the assessment of a patent ductus arteriosus
Creators: David van Laere - Department of Pediatrics, Antwerp University Hospital UZA, Edegem, Belgium
Patrick J McNamara - Departments of Pediatrics and Physiology, University of Toronto, Toronto, ON, Canada
Bart van Overmeire - Department of Neonatology, University Hospital Brussels, Brussels, Belgium
Samir Gupta - University Hospital of North Tees, Durham University, Stockton-on-Tees, United Kingdom
Afif El-Khuffash - Department of Pediatrics, The Royal College of Surgeons in Ireland, Dublin, Ireland
Marilena Savoia - Azienda Ospedaliero-Universitaria S. Maria della Misericordia, Udine, Italy
Christoph E Schwarz - Department of Neonatology, University Children's Hospital of Tübingen, Tübingen, Germany
Willem P de Boode - Department of Neonatology, Radboud University Medical Center, Radboud Institute for Health Sciences, Amalia Children's Hospital, Nijmegen, The Netherlands. willem.deboode@radboudumc.nl
European Special Interest Group ‘Neonatologist Performed Echocardiography’ (NPE)
Resource Type: Journal article
Publication Details: Pediatric research, Vol.84(Suppl 1), pp.46-56
DOI: 10.1038/s41390-018-0077-x
PMID: 30072803
PMCID: PMC6257219
NLM abbreviation: Pediatr Res
ISSN: 0031-3998
eISSN: 1530-0447
Grant note: 11/92/15 / Department of Health
Language: English
Date published: 07/2018
Academic Unit: Stead Family Department of Pediatrics; Neonatology; Internal Medicine
Record Identifier: 9984093484802771

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