Clinical and Echocardiographic Factors Influencing Patent Ductus Arteriosus Treatment in Preterm Neonates.

: We evaluated how pre-treatment clinical and echocardiographic findings influence treatment decisions for patent ductus arteriosus (PDA) in preterm neonates. : Preterm neonates weighing < 1500 g and diagnosed with PDA were enrolled. They were categorized into conservative, medical, and surgical groups based on treatment. : A total of 242 preterm neonates (120 boys and 122 girls) participated, with a mean gestational age of 27.9 ± 2.2 weeks and a birth weight of 1034.3 ± 239.3 g. Multivariate logistic regression revealed that oliguria ( < 0.001), inotropic drug use ( = 0.049), low PDA flow velocity ( = 0.039), and left atrial enlargement ( = 0.002) were significantly associated with medical or surgical treatment decisions. Additionally, a low base deficit prior to medical therapy was associated with the decision to proceed with surgical intervention after medical treatment failure ( = 0.006). : Oliguria, inotropic drug use, low PDA flow velocity, and left atrial enlargement were significantly associated with aggressive treatment decisions in preterm neonates with PDA. Furthermore, a low base deficit influenced the need for surgery following medical therapy failure. Our findings suggest that comprehensive monitoring of both clinical and echocardiographic factors may support treatment decision-making in PDA management in preterm neonates.