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“Shunt index” can be used to predict clinically significant patent ductus arteriosus in premature neonates in early post-natal life

Published online by Cambridge University Press:  02 July 2013

Ece Yapakçı ,
Ayşe Ecevit ,
Birgin Törer ,
Deniz Anuk Ince ,
Mahmut Gökdemir ,
Hande Gülcan  and
Aylin Tarcan
Ece Yapakçı
Affiliation:
Department of Pediatrics, Division of Neonatology, Faculty of Medicine, Baskent University, Ankara, Turkey
Ayşe Ecevit
Affiliation:
Department of Pediatrics, Division of Neonatology, Faculty of Medicine, Baskent University, Ankara, Turkey
Birgin Törer
Affiliation:
Department of Pediatrics, Division of Neonatology, Faculty of Medicine, Baskent University, Ankara, Turkey
Deniz Anuk Ince*
Affiliation:
Department of Pediatrics, Division of Neonatology, Faculty of Medicine, Baskent University, Ankara, Turkey
Mahmut Gökdemir
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, Faculty of Medicine, Baskent University, Ankara, Turkey
Hande Gülcan
Affiliation:
Department of Pediatrics, Division of Neonatology, Faculty of Medicine, Baskent University, Ankara, Turkey
Aylin Tarcan
Affiliation:
Department of Pediatrics, Division of Neonatology, Faculty of Medicine, Baskent University, Ankara, Turkey
*
Correspondence to: D. A. Ince, Baskent University Faculty of Medicine, Cocuk Saglıgı ve Hastalıkları Poliklinigi, Fevzi Çakmak mah. 6. cadde 72/1 Giris kat 06490, Bahcelievler, Cankaya, Ankara, Turkey. Tel: +90 532 7156178; Fax: +90 312 215 75 97; E-mail: denizanuk@yahoo.com
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Abstract

Background: This study aimed to examine the differences between arterial and inferior caval vein oxygen saturation, fractional oxygen extraction, and the shunt index, which were calculated in the diagnosis of patent ductus arteriosus. Methods: Twenty-seven preterm infants were included in this study and were divided into two groups according to patent ductus arteriosus. Among them, 11 (41%) infants had haemodynamically significant patent ductus arteriosus and 16 (59%) did not have significant patent ductus arteriosus. Synchronous arterial and venous blood gases were measured during the first post-natal hours after the insertion of umbilical catheters. The differences between arterial and inferior caval vein oxygen saturation, inferior body fractional oxygen extraction, and the shunt index were calculated. Echocardiography was performed before the 72nd hour of life in a selected group of patients who had haemodynamically significant patent ductus arteriosus. Ibuprofen treatment was administered to patients with patent ductus arteriosus. Echocardiography was performed on the 72nd hour of life in preterm infants without any clinical suspicion of patent ductus arteriosus. Results: The early measured differences between arterial and inferior caval vein oxygen saturation and inferior body fractional oxygen extraction were found to be lower and the shunt index was found to be higher in the haemodynamically significant patent ductus arteriosus group than in the group without haemodynamically significant patent ductus arteriosus. Conclusion: We found that the shunt index, calculated in the first hours of life as ≥63%, predicted haemodynamically significant patent ductus arteriosus with a sensitivity of 78% and specificity of 82% in preterm newborns.

Keywords

Prematurityinferior caval vein oxygen saturationmixed venous oxygen saturationpatent ductus arteriosusfractional oxygen extractionshunt index
Type
Original Articles
Information
Cardiology in the Young , Volume 24 , Issue 4 , August 2014 , pp. 605 - 609
Copyright
Copyright © Cambridge University Press 2013 

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