AI Summary & Key Takeaways
AI InsightBoth ductal diameter and pattern together is important to identify hemodyna- mically of hemodynamically significant PDA.
📌 3 Key Takeaways
Abstract
Objective: Aim of study was to evaluate both ductal diameter (Dd) and pulsed wave Doppler (PWD) patterns of patent ductus arteriosus (PDA), the treatment requirement of different patterns. Methods: In this retropective study evaluation and classification of PDA of 139 preterms born before 34 weeks gestation was performed by color Doppler and PWD. Ratio of left atrium/aortic root were evaluated in parasternal long axis. Ductal patterns were compared with both Dd and left atrium/aortic root ratio. PDA was treated by ibuprofen. The treatment requirement and thrombocyte count of patterns was evaluated. Results: 85,5% of preterms were very low birth weight (<1500 g). Median gestational age was 28,5 (23-34) weeks. Median birth weight was 1050 (750-1850) g. 39 (17,3%) pulmonary hyperten - sion (PH), 43 (19,1%) growing, 68 (30,3%) pulsatile, 75 (33,3%) closing pattern were observed. PH pattern was more often in first three days (p<0,001). There was significantly difference among patterns in term of Dd (p<0,001). The largest Dd was observed in PH pattern the smallest Dd was observed in closing pattern. The need for treatment was higher in pulsatile pattern (52,4% of patients). There was a positive corelation between left atrium/aortic root and ductal diameter in pulsatil, growing and closing pattern except PH pattern. There was no relation bet- ween platelet count and flow paterns (p>0,05). Conclusion: We determined significant relationship between Dd and flow pattern. There was no relationship between ductal pattern and thrombocyte count. Pulsatile pattern were hemodyna- mically significant. Despite greater Dd, treatment requirement in PH pattern was less due to low left-right shunt. Both ductal diameter and pattern together is important to identify hemodyna- mically of hemodynamically significant PDA.
Özet
Amaç: Prematürelerde patent duktus arteriyozus (PDA) boyutunu, pulsed wave Doppler (PWD) akım paternlerini, tedavi gerektiren akım paternlerini tespit etmek. Yöntemler: Bu retrospektif çalışmada 34. gebelik haftasından önce doğan 139 prematüre olgunun PDAları PWD ve renkli Doppler ile değerlendirilerek akım paternleri sınıflandırıldı. Olguların sol atriyum aort kök oranı değerlendirildi. PWD paternleri, duktal çap ve sol atriyum/ aort kök oranları ile karşılaştırıldı. PDA ibuprofen ile tedavi edildi. Paternlerin tedavi gereksi- nimleri ve trombosit sayısı değerlendirildi. Bulgular: 139 pretermin %85,5i 1500 g altında idi. Ortanca gebelik haftası 28,5 (23-34), doğum ağırlığı 1050 (750-1850) g tespit edildi. 39 (%17,3) pulmoner hipertansiyon, 43 (%19,1) büyüyen, 68 (%30,2) pulsatil patern, 75 (%33,3) kapanma paterni, tespit edildi. Pulmoner hipertansiyon paterni ilk üç günde sık gözlendi (p 0.05). Sonuç: Duktal çap ve akım paterni arasında önemli ilişki tespit ettik. Duktal patern ve trombosit sayısı arasında ilişki saptanmadı. Pulsatil paternde hemodinamik önem oranı yüksekti. Pulmoner hipertansiyon paterninde duktus çapı büyük olmasına rağmen duktal şant azdı. Hemodinamik açıdan önemli duktusların tespit edilmesinde hem akım paterni hem de duktal çapın önemli olduğuna inanıyoruz.