Singh Yogen, Chan Belinda, Noori Shahab, Ramanathan Rangasamy
Department of Pediatrics, Division of Neonatology, University of California-UC Davis Children's Hospital, Sacramento, CA 95817, USA.
Department of Pediatrics, Division of Neonatology, University of Utah, Salt Lake City, UT 84132, USA.
J Cardiovasc Dev Dis. 2024 Jun 28;11(7):199. doi: 10.3390/jcdd11070199.
Persistent Patent Ductus Arteriosus (PDA) is prevalent among extremely preterm infants, with its occurrence inversely related to gestational age. A persistent PDA correlates with increased mortality and morbidities such as intraventricular hemorrhage, pulmonary hemorrhage, chronic lung disease, bronchopulmonary dysplasia, and necrotizing enterocolitis as observed clinically. Conversely, numerous randomized controlled trials have failed to demonstrate significant benefits from PDA treatment. One contributing factor to these conflicting findings is that PDA affects each individual differently depending on the cardiovascular decompensation and its hemodynamic impact. PDA management should be based on the hemodynamic significance, rather than just the presence or size of PDA. This comprehensive narrative review paper describes echocardiographic parameters that allow a better understanding of the hemodynamic impact of PDA. A newer modality, like lung ultrasound, is also described here as an adjunct to assess the PDA impact on the lungs from pulmonary overcirculation.
持续性动脉导管未闭（PDA）在极早产儿中很常见，其发生率与胎龄呈负相关。临床观察发现，持续性PDA与死亡率增加以及诸如脑室内出血、肺出血、慢性肺病、支气管肺发育不良和坏死性小肠结肠炎等疾病相关。相反，众多随机对照试验未能证明PDA治疗有显著益处。这些相互矛盾的研究结果的一个促成因素是，PDA对每个人的影响因其心血管失代偿及其血流动力学影响而异。PDA的管理应基于血流动力学意义，而不仅仅是PDA的存在或大小。这篇综合性叙述性综述文章描述了一些超声心动图参数，这些参数有助于更好地理解PDA的血流动力学影响。本文还介绍了一种更新的模式，如肺部超声，作为评估PDA因肺循环过度对肺部影响的辅助手段。
