PT - JOURNAL ARTICLE AU - Laura Dix AU - Mirella Molenschot AU - Johannes Breur AU - Willem de Vries AU - Daniel Vijlbrief AU - Floris Groenendaal AU - Frank van Bel AU - Petra Lemmers TI - Cerebral oxygenation and echocardiographic parameters in preterm neonates with a patent ductus arteriosus: an observational study AID - 10.1136/archdischild-2015-309192 DP - 2016 Nov 01 TA - Archives of Disease in Childhood - Fetal and Neonatal Edition PG - F520--F526 VI - 101 IP - 6 4099 - http://fn.bmj.com/content/101/6/F520.short 4100 - http://fn.bmj.com/content/101/6/F520.full SO - Arch Dis Child Fetal Neonatal Ed2016 Nov 01; 101 AB - Background A haemodynamically significant patent ductus arteriosus (hsPDA) is clinically suspected and confirmed by echocardiographic examination. A hsPDA decreases cerebral blood flow and oxygen saturation by the ductal steal phenomenon.Aim To determine the relationship between echocardiographic parameters, cerebral oxygenation and a hsPDA in preterm infants.Methods 380 preterm infants (<32 weeks gestational age) born between 2008 and 2010 were included. Blinded echocardiographic examination was performed on the second, fourth and sixth day after birth. Examinations were deblinded when hsPDA was clinically suspected. Regional cerebral oxygen saturation (rScO2) was continuously monitored by near-infrared spectroscopy during 72 h after birth, and afterwards for at least 1 h before echocardiography. Echocardiographic parameters included ductal diameter, end-diastolic flow in the left pulmonary artery, left atrium/aorta ratio and ductal flow pattern.Results rScO2 was significantly related only to ductal diameter over time. Mixed modelling analysed the course of rScO2 over time, where infants were divided into four groups: a closed duct, an open haemodynamically insignificant duct (non-sPDA), a hsPDA, which was successfully closed during study period (SC hsPDA) or a hsPDA, which was unsuccessfully closed during study period (UC hsPDA). SC hsPDA infants showed the highest rScO2 on day 6, while UC hsPDA infants had the lowest rScO2 values.Conclusions Ductal diameter is the only echocardiographic parameter significantly related to cerebral oxygenation over time. Cerebral oxygenation takes a different course over time depending on the status of the duct. Low cerebral oxygenation may be suggestive of a hsPDA.