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O-034 Half Systolic Decay Time (½sdt) Of Ductal Flow Measured By Echocardiography Would Predict Need For Treatment Of Patent Ductus Arteriosus (pda) In Extremely Premature Neonate
  1. A Kulkarni1,
  2. JS Carvalho2,
  3. J Richards1
  1. 1Neonatology, St George’s Hospital NHS Trust, London, UK
  2. 2Fetal Medicine, St George’s Hospital NHS Trust Royal Brompton Hospital NHS Trust, London, UK

Abstract

Aim To evaluate the utility of half systolic decay time (½SDT) of ductal flow measured by Doppler echocardiography in predicting PDA treatment in extremely premature babies.

Methods We prospectively recruited babies ≤30 weeks gestation. We performed serial echocardiograms (<48 hr of life [scan1], day 7 [scan2], week 2 [scan3], week 3 [scan4], week 4 [scan5]). In babies with PDA, we measured the time needed to halve peak systolic velocity (½SDT) across the duct using continuous wave Doppler. The clinical team was blinded to the research assessment.

Results A total of 48 babies were recruited to the study over a one-year period. Median gestational age was 26 weeks (range 23 -29) and mean birth weight (±SD) was 909g (±295). Seven babies (14%) were treated for PDA, including two needing surgical ligation. The ½SDT measured on scan2, was significantly shorter in the treated babies (p = 0.0172). In this study population ½SDT <90 ms measured on day 7 (scan2) was 100% specific in predicting need for PDA treatment. The parameter had a positive predictive value of 100% with sensitivity of 62.5%. The negative predictive value was 88% with diagnostic accuracy of 90%.

Conclusion In this population at our centre, all babies <30 weeks gestation with ½SDT <90 ms on day 7 of life were treated for PDA by clinicians blinded to this assessment. We believe that ½SDT warrants further investigation as an early marker for targeting PDA treatment in extremely preterm babies.

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