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Clinical findings that suggest a hemodynamically significant patent ductus arteriosus (PDA) in preterm infants

Clinical findings that suggest a hemodynamically significant patent ductus arteriosus (PDA) in preterm infants
Clinical findings
Need for substantial respiratory support:
  • MAP ≥8 cm H2O, and/or
  • FiO2 >0.4
Pulmonary hemorrhage
Widened pulse pressure (eg, DBP <50% of SBP or >25 mmHg difference between SBP and DBP)
Cardiomegaly and/or pulmonary edema on chest radiograph
Hypotension requiring vasoactive infusion(s)
Signs of hypoperfusion:
  • Oliguria (urine output <1 mL/kg/hr) or AKI (Cr >1.2 mg/dL)
  • Metabolic acidosis not otherwise explained
This table summarizes clinical findings that suggest a hemodynamically significant PDA in preterm neonates. These findings should be assessed in conjunction with echocardiographic findings. The determination of whether a PDA is hemodynamically significant is typically based upon multiple findings rather than a single isolated finding. Refer to UpToDate topics on PDA in preterm infants for additional details.
PDA: patent ductus arteriosus; MAP: mean airway pressure; FiO2: fraction of inspired oxygen; DBP: diastolic blood pressure; SBP: systolic blood pressure; AKI: acute kidney injury; Cr: creatinine.
Graphic 141521 Version 1.0

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