الفهرس 
PATENT DUCTUS ARTERIOSUSOnly 14 pages are availabe for public view
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Abstract
Abstract
Background: Patent ductus arteriosus (PDA) poses a diagnostic and a therapeutic dilemma for neonatologists. Although echocardiography (Echo) has been the gold standard diagnostic tool for PDA, it requires a trained cardiologist or neonatologist to perform and it is usually not available around the clock. Echo provides also a single rather than continuous assessment of the sick neonates, whose hemodynamic statuses change quickly. Electrocardiometry (EC) is a new device for continuous hemodynamic monitoring of neonates.
Aim of the work: To evaluate the accuracy and precision of EC in comparison to ECHO in assessment of PDA response to treatment in preterm neonates.
Patients and methods: This diagnostic accuracy study was conducted in the neonatal intensive care units (NICUs) of Children hospital of Ain Shams University, Cairo, between (1/5/2021 to 31/3/2022). The study was approved by the ethical committee of Ain Shams University. Preterm neonates<35weeks admitted during the study period were eligible for enrollment. Neonates with hemodynamically non-significant PDA and those with other congenital anomalies were excluded.
Results: Forty neonates were enrolled (27 females, 13 males). Closure rate of oral ibuprofen was 100% (39/39) while paracetamol failed to close the PDA in one patient (closure success 0%). Echo and EC didn’t agree upon the tested parameters (stroke volume (SV), cardiac index (CI), ejection fraction (EF), cardiac output (CO) but agreed in measuring heart rate (HR). In patients with inotropes, Echo detected significant changes in CO (p=0.044) and CI (p=0.047) but no changes in SV, EF and HR (p= 0.41, 0.506 & 0.105 respectively). In patients who needed mechanical ventilation, Echo detected significant changes in CI (p=0.008), CO (0.006) and SV (0.042). No changes were detected in any parameter by EC in patients who needed either inotropes or mechanical ventilation (p>0.05 in all parameters).
Conclusion: While EC is safe and an easy to apply device, our results show that electrocardiometry is not as accurate as the echocardiography in predicting the hemodynamic changes that might correspond to the closure of PDA in preterm neonates with hemodynamically significant PDA.