A Hemodynamically Significant Patent Ductus Arteriosus Does Not Affect Cerebral or Renal Tissue Oxygenation in Preterm Infants

Background: Patent ductus arteriosus (PDA) is common in preterm infants and is associated with significant morbidity. To determine whether the PDA is hemodynamically significant (HSDA), several echocardiographic parameters have been suggested, including retrograde diastolic blood flow in the descending aorta (Dao). Objective: To assess the impact of an HSDA, including retrograde diastolic flow in the Dao, on regional tissue oxygen saturation (rSO 2 ) and extraction measured by near-infrared spectroscopy (NIRS). Methods: This is a prospective observational cohort study in which we included preterm infants (GA <32 weeks) who underwent echocardiographic screening because of clinical signs of an HSDA within 2 weeks after birth. We measured cerebral and renal rSO 2 on the day of echocardiography. HSDA was diagnosed if left-to-right shunting through the PDA was accompanied by left atrial-to-aortic root ratio >1.4 and/or left pulmonary artery end-diastolic flow velocity >0.2 m/s and/or retrograde diastolic blood flow in the Received: July 25, 2015 Accepted after revision: March 1, 2016 Published online: April 19, 2016 Michelle E. van der Laan, MD, PhD Division of Neonatology, Beatrix Children’s Hospital University Medical Center Groningen, University of Groningen Hanzeplein 1, NL–9713 GZ Groningen (The Netherlands) E-Mail m.e.van.der.laan @ umcg.nl © 2016 The Author(s) Published by S. Karger AG, Basel 1661–7800/16/1102–0141$39.50/0 www.karger.com/neo Th is article is licensed under the Creative Commons AttributionNonCommercial-NoDerivatives 4.0 International License (CC BYNC-ND) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes as well as any distribution of modifi ed material requires written permission. D ow nl oa de d by : 54 .7 0. 40 .1 1 10 /6 /2 01 7 10 :0 9: 01 P M