Predictive value of cerebral doppler resistive index in premature infants with hemodynamically significant patent ductus arteriosus.
BACKGROUND To evaluate cerebral Doppler ultrasonography parameters for predicting hemodynamically significant patent ductus arteriosus (hsPDA) in very premature infants. METHODS This prospective cohort study included preterm infants (gestational age [GA] ≤ 30 weeks) who were admitted to a tertiary neonatal intensive care unit. Blood flow velocities, resistive and pulsatility indices of anterior cerebral artery (ACA) were measured at the first 24 and 72 h of life using transcranial Doppler ultrasound. The pediatric cardiologist performed echocardiographic evaluations of all infants at 72 h postnatally. RESULTS A total of 77 infants (27 and 50 in the hsPDA and non-hsPDA groups) were included. Mean GA was 27.9 ± 2 and 28.6 ± 1.6 weeks, and mean birth weight was 1056 ± 248 and 1106 ± 269 g in the hsPDA and non-hsPDA groups, respectively; (p = 0.094, p = 0.46). Infants in the hsPDA group had significantly higher pulsatility index and resistive index (RI) than those in the non-hsPDA group at 24 h (p < 0.001 and p < 0.001, respectively). Multivariate analysis revealed that ACA RI above 0.75 at 24 h was an independent predictor for hsPDA. CONCLUSION ACA RI measurement may have a potential role, in combination with other clinical parameters, in the early prediction of hsPDA in premature infants; however, further studies are required to validate these findings.