• Roxane Desandes, Jean-Marc Jellimann, Mahmoud Rouabah, Fouad Haddad, Emmanuel Desandes, Farid Boubred, Denis S Semama, Rachel Vieux, and Jean-Michel Hascoët.
• Department of Neonatology, Maternite Regionale Universitaire, Nancy, France.
• Pediatr Crit Care Me. 2012 May 1;13(3):324-7.

ObjectiveTo evaluate echocardiography criteria in predicting the response to ibuprofen treatment.DesignA prospective cohort study of preterm infants untreated or treated with ibuprofen for patent ductus arteriosus.SettingThree academic neonatal intensive care units.PatientsTwo hundred fifty-two preterm infants of 27-31 wks gestation.InterventionsIbuprofen treatment within the first 5 days of life was indicated when at least two out of four conventional echocardiography criteria were observed: ductal diameter >2 mm, left-right ductal shunt maximum velocity <2 m/sec, mean flow velocity in left pulmonary artery >0.4 m/sec, and end-diastolic flow velocity in left pulmonary artery >0.2 m/sec.Measurements And Main ResultsOf the infants analyzed, 135 had a closed ductus at an average age of 1.9 ± 0.9 days, and 43 had an open ductus but <2 predefined criteria. Seventy-four infants (29%) received ibuprofen on day 2.2 ± 1.1. Sixteen infants failed ibuprofen and nine had to undergo surgical ligation. The left-right ductal shunt maximum velocity criterion had the best negative predictive value for treatment response, while the ductal diameter criterion had the best positive predictive value.ConclusionsEchocardiography may be a useful tool to help patent ductus arteriosus management. A combined use of ductal diameter and left-right ductal shunt maximum velocity criteria allows a more accurate prediction of the response of infants with patent ductus arteriosus to ibuprofen treatment.

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