Ahmed Mostafa El-Mahdy, Ahmed Hamdy Shabana, Heba Saeed El-Mahdy and Mostafa Mohammed Awny
Background: Children with a hemodynamically considerable patent ductus arteriosus (hsPDA) may physiologically modify through developing a higher-than-normal CO, which could serve as a substitute for an extensive PDA or as sign of a poor outcome following pharmacological PDA closure. Electrical cardiometry (EC) can continuously and non-invasively evaluate various hemodynamic parameters. This study aimed to use electrical cardiometry EC to monitor hemodynamic alternations during pharmaceutical termination of hemodynamically significant patent ductus arteriosus (hsPDA) in preterm neonates.
Methods: In this prospective observational study at Tanta University Hospitals, NICU department, 80 preterm neonates with GA between 28 and 35 weeks were enrolled, 40 of them with hsPDA received I.V paracetamol treatment course, and 40 hemodynamically stable preterm as control. 20 responders were matched with their GA and weight to 20 non-responders.
Results: baseline SV and CO were significantly higher in hsPDA 40 preterm than control while baseline SVR was significantly higher in control. Also, SV and CO were significantly higher in Non-Responders than Responders at baseline. In Responders, SV and CO were significantly decreased while SVR increased after treatment. In Non-Responders, SV and CO were significantly increased while SVR decreased after treatment. Baseline SVR showed weak significant positive correlation with LA/Ao ratio in responders.
Conclusion: Preterm neonates with hsPDA had higher baseline CO, SV, duct size and LA/Ao ratio compared to the control group, ln contrast with respondents, those who didn't exhibited greater baseline CO and SV.
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