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Assessing Patent Ductus Arteriosus (PDA) Significance on Cardiac Output by Whole-Body Bio-impedance

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Abstract

We evaluated the effectiveness of a whole-body bioimpedance device (NICaS®, NI Medical, Petach Tikva, Israel) to predict the presence of a hemodynamically significant patent ductus arteriosus (PDA) in premature infants. A total of 36 infants less than 35 week’s gestation age and birth weights of less than 1750 g were included in the study. Using the NICaS® device, we obtained whole-body bioimpedance measurements of stroke volume index (SI), cardiac output index (CI) and total peripheral resistance index. A total of 61 measurements were taken together with echocardiograph imaging. The study population was divided into three groups according to the echocardiograph results: group 1—small PDA, group 2—moderate PDA, and group 3—large PDA. Both SI and CI significantly increased from a median value of 22.6 ml/m2 and 3.4 l/min/m2 to 23.8 and 3.7, to 39.8 and 5.4 between groups 1, 2 and 3 respectively. The difference was statistically significant between groups 1 and 3 (P = 0.005 for SI and P = 0.002 for CI) and between groups 2 and 3 (P = 0.037 for SI and P = 0.05 for CI). We found statistically significant differences in SI and CI between infants with large PDAs and infants with no or small and medium PDAs. We suggest that these differences can be used in real time, in addition to echocardiography, in assessing the presence of significant PDAs.

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References

  1. Benitz WE (2016) Committee on F, Newborn AAoP. Patent ductus arteriosus in preterm infants. Pediatrics 137–143

  2. Heuchan AM, Clyman RI (2014) Managing the patent ductus arteriosus: current treatment options. Arch Dis Child Fetal Neonatal Ed 99:F431–F436

    Article  Google Scholar 

  3. Rolland A, Shankar-Aguilera S, Diomande D, Zupan-Simunek V, Boileau P (2015) Natural evolution of patent ductus arteriosus in the extremely preterm infant. Arch Dis Child Fetal Neonatal Ed 100:F55–F58

    Article  Google Scholar 

  4. Garland J, Buck R, Weinberg M (1994) Pulmonary hemorrhage risk in infants with a clinically diagnosed patent ductus arteriosus: a retrospective cohort study. Pediatrics 94:719–723

    CAS  Google Scholar 

  5. Sehgal A, McNamara PJ (2012) The ductus arteriosus: a refined approach! Semin Perinatol 36:105–113

    Article  Google Scholar 

  6. Benitz WE, Bhombal S (2017) The use of non-steroidal anti-inflammatory drugs for patent ductus arteriosus closure in preterm infants. Semin Fetal Neonatal Med 22:302–307

    Article  Google Scholar 

  7. Prescott S, Keim-Malpass J (2017) Patent ductus arteriosus in the preterm infant: diagnostic and treatment options. Adv Neonatal Care 17:10–18

    Article  Google Scholar 

  8. El-Mashad AE, El-Mahdy H, El Amrousy D, Elgendy M (2017) Comparative study of the efficacy and safety of paracetamol, ibuprofen, and indomethacin in closure of patent ductus arteriosus in preterm neonates. Eur J Pediatr 176:233–240

    Article  CAS  Google Scholar 

  9. Ohlsson A, Shah PS (2018) Paracetamol (acetaminophen) for patent ductus arteriosus in preterm or low birth weight infants. Cochrane Database Syst Rev 4:CD010061

    Google Scholar 

  10. Pezzati M, Vangi V, Biagiotti R, Bertini G, Cianciulli D, Rubaltelli FF (1999) Effects of indomethacin and ibuprofen on mesenteric and renal blood flow in preterm infants with patent ductus arteriosus. J Pediatrics 135:733–738

    Article  CAS  Google Scholar 

  11. Lee LC, Tillett A, Tulloh R, Yates R, Kelsall W (2006) Outcome following patent ductus arteriosus ligation in premature infants: a retrospective cohort analysis. BMC Pediatrics 6:15

    Article  PubMed  Google Scholar 

  12. Borras-Novell C, Riverola A, Aldecoa-Bilbao V, Izquierdo M, Domingo M, Iriondo M (2018) Clinical outcomes after more conservative management of patent ductus arteriosus in preterm infants. J Pediatria. https://doi.org/10.1016/jped.2018.10.004

    Article  Google Scholar 

  13. Chock VY, Goel VV, Palma JP, Luh TM, Wang NA, Gaskari S et al (2017) Changing management of the patent ductus arteriosus: effect on neonatal outcomes and resource utilization. Am J Perinatol 34:990–995

    Article  Google Scholar 

  14. Benitz WE (2012) Patent ductus arteriosus: to treat or not to treat? Arch Dis Child Fetal Neonatal Ed 97:F80–F82

    Article  Google Scholar 

  15. Benitz WE (2010) Treatment of persistent patent ductus arteriosus in preterm infants: time to accept the null hypothesis? J Perinatol 30:241–252

    Article  CAS  Google Scholar 

  16. Alagarsamy S, Chhabra M, Gudavalli M, Nadroo AM, Sutija VG, Yugrakh D (2005) Comparison of clinical criteria with echocardiographic findings in diagnosing PDA in preterm infants. J Perinat Med 33:161–164

    Article  Google Scholar 

  17. Cybulski G, Strasz A, Niewiadomski W, Gasiorowska A (2012) Impedance cardiography: recent advancements. Cardiol J 19:550–556

    Article  Google Scholar 

  18. Oh G, Wong C, Begin B, Salsbery K, Sutherland S, Chaudhuri A (2014) Whole-body single-frequency bioimpedance analysis in pediatric hemodialysis patients. Pediatric Nephrol 29:1417–1423

    Article  Google Scholar 

  19. Djordjevich L, Sadove MS (1981) Basic principles of electrohaemodynamics. J Biomed Eng 3:25–33

    Article  CAS  Google Scholar 

  20. Cohen AJ, Arnaudov D, Zabeeda D, Schultheis L, Lashinger J, Schachner A (1998) Non-invasive measurement of cardiac output during coronary artery bypass grafting. Eur J Cardio-Thorac Surg 14:64–69

    Article  CAS  Google Scholar 

  21. Beck R, Milella L, Labellarte C (2018) Continuous non-invasive measurement of stroke volume and cardiac index in infants and children: comparison of Impedance Cardiography NICaS(R) vs CardioQ(R) method. La Clinica terapeutica 169:e110–e113

    CAS  Google Scholar 

  22. Cotter G, Moshkovitz Y, Kaluski E, Cohen AJ, Miller H, Goor D et al (2004) Accurate, noninvasive continuous monitoring of cardiac output by whole-body electrical bioimpedance. Chest 125:1431–1440

    Article  Google Scholar 

  23. Leitman M, Sucher E, Kaluski E, Wolf R, Peleg E, Moshkovitz Y et al (2006) Non-invasive measurement of cardiac output by whole-body bio-impedance during dobutamine stress echocardiography: clinical implications in patients with left ventricular dysfunction and ischaemia. Eur J Heart Fail 8:136–140

    Article  Google Scholar 

  24. Paredes OL, Shite J, Shinke T, Watanabe S, Otake H, Matsumoto D et al (2006) Impedance cardiography for cardiac output estimation: reliability of wrist-to-ankle electrode configuration. Circ J 70:1164–1168

    Article  Google Scholar 

  25. Tanino Y, Shite J, Paredes OL, Shinke T, Ogasawara D, Sawada T et al (2009) Whole body bioimpedance monitoring for outpatient chronic heart failure follow up. Circ J 73:1074–1079

    Article  Google Scholar 

  26. Kubicek WG, Kottke J, Ramos MU, Patterson RP, Witsoe DA, Labree JW et al (1974) The Minnesota impedance cardiograph- theory and applications. Biomed Eng 9:410–416

    CAS  Google Scholar 

  27. Sanchez R, de la Blanca A, Sanchez Luna M, Gonzalez Pacheco N, Arriaga Redondo M, Navarro PN (2018) Electrical velocimetry for non-invasive monitoring of the closure of the ductus arteriosus in preterm infants. Eur J Pediatr 177:229–235

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Neonatology, Kaplan Medical Center, P.O. Box 1, Rehovot, Israel

    Ilya Rosin, Yael Simpson & Orna Flidel-Rimon

  2. Unit of Pediatric Cardiology, Hebrew University, Jerusalem, Israel

    Ruth Rafaeli Rabin & Avraham Matitiau

Authors
  1. Ruth Rafaeli Rabin
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  2. Ilya Rosin
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  3. Avraham Matitiau
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  4. Yael Simpson
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  5. Orna Flidel-Rimon
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Correspondence to Orna Flidel-Rimon.

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Rafaeli Rabin, R., Rosin, I., Matitiau, A. et al. Assessing Patent Ductus Arteriosus (PDA) Significance on Cardiac Output by Whole-Body Bio-impedance. Pediatr Cardiol 41, 1386–1390 (2020). https://doi.org/10.1007/s00246-020-02380-5

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  • DOI: https://doi.org/10.1007/s00246-020-02380-5

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