Table 3.
Echocardiographic criteria to define hemodynamically significant PDA (hsPDA), representing the cut-off for treatment according to the authors, and Heterogeneous characteristics of the studied populations.
| Authors | Year | PDA size | LA/Ao ratio | (i) Studied population (ii) Postnatal age at diagnosis |
(i) Birth weight (ii) Gestational age |
|---|---|---|---|---|---|
| Roofthooft et al.1 [22] | 2015 | >2 mm | >1,6 | (i) 33 VLBW with these echo features (ii) Median 51 days group A, 30 days group B, none in group C2 |
(i) <1500 g (ii) <28 w |
|
| |||||
| Dash et al. [85] | 2015 | ≥1,5 mm | >1,5 | (i) 77 preterms with these echo features (ii) <48 hours |
(i) ≤1500 (ii) Mean: 28,5 w Para group, 28,9 w Ibu group |
|
| |||||
| Peňa-Juárez et al.3 [123] | 2015 | ≥1 mm | >1,8 | (i) 10 preterms with these echo features (ii) <10 days |
(i) 840–1600 g (ii) 30–36 w |
|
| |||||
| Härkin et al. [108] | 2016 | Diameter > 50% LPA | >1,4 | (i) Among 63 screened VLBW patients, 48 had these echo features and underwent randomization (76,2%) (ii) n.e. |
(i) Mean: 1220 g Para group, 1120 placebo group (ii) <32 w |
|
| |||||
| Valerio et al.4 [87] | 2016 | ≥1,4 mm/Kg | ≥1,4 | (i) Among the 196 studied preterms, 102 had PDA (52%), and, among these patients, 48 (47,1%) had these echo features (ii) Echo performed at 48–72 hours |
(i) Mean: 853,3 g “first-line” group, 887,7 g “rescue group”5 (ii) 23–32 w |
|
| |||||
| Bagheri et al. [18] | 2016 | >1,5 mm | >1,2 | (i) 160 patients enrolled for hsPDA but 31 excluded. Final group: 129 patients (ii) ≤14 days |
(i) Mean: 1646 g Para group, 1642 g Ibu group (ii) <37 w |
|
| |||||
| El-Mashad et al. [55] | 2015 | >1,5 mm | >1,6 | (i) 300 preterms with these echo features (ii) ≤ 14 days |
<1500 g <28 w |
|
| |||||
| Dani et al. [84] | 2016 | >1,5 mm | >1,3 | (i) On course (ii) 48–72 hours |
(i) n.e. (ii) 25–31+6 w |
|
| |||||
| Tofé Valera et al. [117] | 2016 | >2 mm | >1,5 | (i) 3 preterms (ii) 3, 5 and 14 days |
(i) <1900 g (ii) <32 w |
|
| |||||
| Yang et al. [88] | 2016 | >1,4 mm | >1,4 | (i) Among 96 neonates with these echo features, 87 underwent randomization (ii) 15 hours–10 days |
(i) Mean: 2091 g Ibu group, 2219 g Para group (ii) <37 w |
|
| |||||
| Memisoglu et al. [118] | 2016 | >1.4 mm/kg | >1.4 | (i) 11 preterms (ii) n.k. |
(i) 415–1580 g (ii) 23–30+3 w |
|
| |||||
| Benitz and Committee on Fetus and Newborn [6] | 2016 | ≥1,5 mm | ≥1,5 | (i) n.e. (ii) n.e. |
(i) n.e. (ii) n.e. |
|
| |||||
| Tan and Baral [12] | 2016 | ≥1,4 mm | ≥1,5 | (i) n.e. (ii) n.e. |
(i) n.e. (ii) 25–37 w |
|
| |||||
| Vettukattil [33] | 2016 | >1.4 mm | >1.4 | (i) n.e. (ii) n.e. |
(i) n.e. (ii) n.e. |
PDAsize: mm or mm/Kg; PA = Pulmonary Artery; La/Ao ratio = left atrium/aorta diameter; LVO/FVC = Left ventricular output and systemic flow through superior vena cava; LPA = Left Pulmonary Artery; Qp/Qs = Pulmonary/Systemic Flow Ratio; Para = paracetamol; Ibu = ibuprofen; echo = echocardiographic; w = weeks; g = grams; n.e. = not explained in the text; n.k. = not known data; 1PDA/LPA > 0,8; 2Group A: paracetamol first choice for ibuprofen primary contraindication. Group B: paracetamol after ibuprofen incomplete courses for development of contraindication. Group C: paracetamol after failure of two complete ibuprofen courses; 3Qp/Qs ratio > 1,8; 4LVO/FVC ratio ≥ 4. 5“First-line” group: paracetamol as first-choice therapy for ibuprofen contraindications. “Rescue” group: paracetamol after ibuprofen failure or for development of contraindications during its administration.