Abstract
By means of probability analysis we have compared the diagnostic value of clinical symptoms, m-mode echocardiographic measurements and peripheral arterial flow, assessed by continuous-wave Doppler, in preterm infants with symptomatic patent ductus arteriosus (PDA). Data were obtained in 29 infants with PDA and in 29 controls. The most sensitive clinical finding was a hyperactive precordium. Bounding pulses and a heart murmur were absent in 15% and 20%, respectively of the patients with PDA. M-mode echocardiographic measurements were rather specific for the detection of a PDA but less sensitive. Diastolic backflow in the brachial and femoral arteries was present in the majority of patients with PDA and absent in about 67% of the controls. The values in probability analysis, however, were too low to base a therapy on these findings. The highest sensitivity and specificity (100% each) was found for a disturbed cerebral blood flow with absent or retrograde diastolic perfusion estimated by Doppler sonography.
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Abbreviations
- PDA:
-
patent ductus arteriosus
- cw-Doppler:
-
continuous-wave Doppler
- SF:
-
shortening fraction
- LPEP/LVET, RPEP/RVET:
-
left and right ventricular systolic time intervals
- R/F:
-
retrograde/forward flow
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Dedicated to Professor Dr. E. Kleihauer on the accasion of his 60th birthday
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Kupferschmid, C., Lang, D. & Pohlandt, F. Sensitivity, specificity and predictive value of clinical findings, m-mode echocardiography and continuous-wave Doppler sonography in the diagnosis of symptomatic patent ductus arteriosus in preterm infants. Eur J Pediatr 147, 279–282 (1988). https://doi.org/10.1007/BF00442695
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DOI: https://doi.org/10.1007/BF00442695