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Cardiopulmonary Ultrasound-Guided Treatment of Premature Infants with Respiratory Failure and Patent Ductus Arteriosus: A Randomized, Controlled Trial

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Abstract

Objectives

To evaluate the role of cardiopulmonary ultrasonography in the treatment of preterm infants with respiratory failure combined with patent ductus arteriosus (PDA).

Methods

A single-center, prospective, randomized, controlled trial of premature infants born in the authors’ hospital with a birth weight ≤ 1500 g and respiratory failure combined with PDA was conducted from January 2020 to December 2021. The included infants were randomly assigned to the cardiopulmonary ultrasound-guided therapy group or the traditional therapy group. The primary outcome of this study was data on respiratory support and PDA.

Results

A total of 76 premature infants were included in the study. There were 39 patients in the cardiopulmonary ultrasound-guided therapy group and 37 patients in the traditional therapy group. There was no difference in the baseline data, and the cardiopulmonary ultrasound-guided therapy group had a higher initial positive end-expiratory pressure [difference in median = −1.5 cm H2O, 95% confidence interval (CI): −2.0 to −1.0, p < 0.0001], earlier use of ibuprofen to close the PDA (difference in median = 2.5 d, 95% CI: 1.0–4.0, p = 0.004), fewer patients requiring invasive respiratory support [risk ratio (RR) = 0.63, 95% CI: 0.41–0.99, p = 0.04], and a lower incidence of moderate to severe bronchopulmonary dysplasia (RR = 0.44, 95% CI: 0.44–0.96, p = 0.04). There was no difference in the incidence of adverse events.

Conclusions

For premature infants with respiratory failure combined with PDA, cardiopulmonary ultrasonography can better guide respiratory support. The timely administration of drugs helps treat PDA, thereby decreasing the risk of intubation and BPD.

Trial Registration

https://www.trialos.com/index/, TRN: 20220420024607012, date of registration: 2022/03/28, retrospectively registered.

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Funding

This work was supported by the Natural Science Foundation of Zhejiang Province (grant number LY20H040008) and Zhejiang Provincial Medical and Health Technology Project (grant number 2023KY164). The funding source played no role in the study design, data collection, data analysis, data interpretation, writing of the report, or decision to submit the report for publication.

Author information

Authors and Affiliations

  1. The Fourth Clinical College, Zhejiang University of Traditional Chinese Medicine, Hangzhou, China

    Zhiqun Zhang, Xinrui Lou, Luyi Hua & Xinhui Jia

  2. Department of Neonatology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, No. 261 Huansha Road, Hangzhou, China

    Zhiqun Zhang & Lili Xu

  3. Department of Ultrasound, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China

    Min Zhao

Authors
  1. Zhiqun Zhang
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  2. Xinrui Lou
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  3. Luyi Hua
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  4. Xinhui Jia
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  5. Lili Xu
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  6. Min Zhao
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Contributions

ZZ and LH developed the study protocol, implemented the study and collected data; MZ helped in interpretation of outcome measurement; XJ and XL helped in protocol development, supervised implementation, and contributed to writing the manuscript; ZZ supervised implementation and critical review of the manuscript. All authors have reviewed the manuscript and approved the submitted version. ZZ will act as the guarantor for this paper.

Corresponding author

Correspondence to Zhiqun Zhang.

Ethics declarations

Ethical Approval

This study was reviewed and approved by the ethics committee (Ethical lot number: IIT-20220418-0058).

Consent to Participate

Detailed information about the study was given and explained to the participants as well as to their parents who agreed to participate in the study, after which they signed an informed consent and assent form.

Conflict of Interest

None.

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Zhang, Z., Lou, X., Hua, L. et al. Cardiopulmonary Ultrasound-Guided Treatment of Premature Infants with Respiratory Failure and Patent Ductus Arteriosus: A Randomized, Controlled Trial. Indian J Pediatr 90, 1103–1109 (2023). https://doi.org/10.1007/s12098-023-04489-w

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  • DOI: https://doi.org/10.1007/s12098-023-04489-w

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