# Clinical and Echocardiographic Factors Influencing Patent Ductus Arteriosus Treatment in Preterm Neonates

## TL;DR

This study identifies clinical and echocardiographic factors that influence treatment decisions for patent ductus arteriosus in preterm neonates.

## Contribution

The study reveals specific clinical and echocardiographic indicators that guide treatment choices for PDA in preterm infants.

## Key findings

- Oliguria, inotropic drug use, low PDA flow velocity, and left atrial enlargement are linked to medical or surgical treatment decisions.
- A low base deficit before medical therapy is associated with the need for surgery after treatment failure.
- Comprehensive monitoring of clinical and echocardiographic factors can support treatment decisions for PDA in preterm neonates.

## Abstract

Objective: We evaluated how pre-treatment clinical and echocardiographic findings influence treatment decisions for patent ductus arteriosus (PDA) in preterm neonates. Study Design: Preterm neonates weighing < 1500 g and diagnosed with PDA were enrolled. They were categorized into conservative, medical, and surgical groups based on treatment. Results: A total of 242 preterm neonates (120 boys and 122 girls) participated, with a mean gestational age of 27.9 ± 2.2 weeks and a birth weight of 1034.3 ± 239.3 g. Multivariate logistic regression revealed that oliguria (p < 0.001), inotropic drug use (p = 0.049), low PDA flow velocity (p = 0.039), and left atrial enlargement (p = 0.002) were significantly associated with medical or surgical treatment decisions. Additionally, a low base deficit prior to medical therapy was associated with the decision to proceed with surgical intervention after medical treatment failure (p = 0.006). Conclusions: Oliguria, inotropic drug use, low PDA flow velocity, and left atrial enlargement were significantly associated with aggressive treatment decisions in preterm neonates with PDA. Furthermore, a low base deficit influenced the need for surgery following medical therapy failure. Our findings suggest that comprehensive monitoring of both clinical and echocardiographic factors may support treatment decision-making in PDA management in preterm neonates.