Association between patent ductus arteriosus flow and home oxygen therapy in extremely preterm infants

• Published in: Pediatric research Vol. 96; no. 1; pp. 208 - 215
• Main Authors: Termerova, Jana, Kubena, Ales A, Liska, Karel, Tomek, Viktor, Plavka, Richard
• Format: Journal Article
• Language: English
• Published: United States Nature Publishing Group 01.07.2024
• Subjects: Ductus Arteriosus, Patent - diagnostic imaging; Ductus Arteriosus, Patent - physiopathology; Ductus Arteriosus, Patent - therapy; Echocardiography; Female; Gestational Age; Hemodynamics; Home Care Services; Humans; Infant, Extremely Premature; Infant, Newborn; Male; Newborn babies; Oxygen Inhalation Therapy; Oxygen therapy; Premature babies; Prospective Studies; Vena Cava, Superior - diagnostic imaging; Vena Cava, Superior - physiopathology
• ISSN: 0031-3998; 1530-0447; 1530-0447
• DOI: 10.1038/s41390-024-03120-8

Central blood flow measurements include the estimation of right and left ventricular output (RVO, LVO), superior vena cava (SVC) flow, and calculated patent ductus arteriosus (PDA) flow. We aimed to provide an overview of the maturation patterns of these values and the relationship between PDA flow and the need for home oxygen therapy. This prospective single-center study was conducted in infants born at <26 weeks of gestation. We performed echocardiographic measurements five times during their life (from the 4th post-natal day to the 36th postmenstrual week). Sixty patients with a mean birth weight of 680 (590, 760) g were included. Postnatal development of LVO and PDA flow peaked at the end of the second postnatal week (427 and 66 mL/kg/min, respectively). The RVO increased between days 4 and 7-8. The SVCF was most stable. The development curves of PDA flow differed between the groups with (n = 28; 47%) and without home oxygen therapy. We present the central blood flow values and their postnatal development in infants <26 weeks of gestation. This study demonstrates the association between PDA flow and the future need for home oxygen therapy. This study enriches our knowledge of the long-term development of central blood flow parameters and derived patent ductus arteriosus (PDA) flow in extremely preterm infants (<26 weeks). While pulmonary resistance decreased, PDA flow continued to increase from day 4 to the end of the second week of life. Similarly, left ventricular output increased as a marker of preload. The superior vena cava flow remained stable. The observed association between PDA flow and an unfavorable respiratory outcome is important for future studies focusing on the prevention of chronic lung disease.