123 - Lung ultrasound score correlates with patent ductus arteriosus shunt volume assessed by echocardiography in very low birth weight infants

Monday, May 1, 2023

9:30 AM – 11:30 AM ET

Poster Number: 123
Publication Number: 123.427

Eva Vierge Hernán, Hospital Clinico San Carlos, Madrid, Madrid, Spain; María José Rodriguez, Hospital Clínico San Carlos, Madrid, Madrid, Spain; Araceli Corredera Sánchez, Clínico San Carlos Hospital, Madrid, Madrid, Spain; Niki Oikonomopoulou, Hospital Clínico San Carlos, Madrid, Madrid, Spain; Cristina Cortés-Ledesma, Clinico San Carlos Hospital, Madrid, Madrid, Spain; Jose Martínez-Orgado, Hospital Clinico San Carlos - IdISSC, Madrid, Madrid, Spain; Luis Arruza, Hospital Clinico San Carlos, Madrid, Madrid, Spain

Presenting Author(s)

EV

Eva Vierge Hernán, Md (she/her/hers)

MD
Hospital Clinico San Carlos
Madrid, Madrid, Spain

Background: Patent ductus arteriosus (PDA) is a frequent condition in very low birth weight infants (VLBWI). The assessment of its clinical relevance and consequently the need for treatment can be difficult to determine and remains controversial. Different scores have been developed with the aim of guiding management.The pulmonary edema caused by PDA overcirculation could be evaluated by lung ultrasound (LUS) in a semi quantitative way and thus provide further information on the significance of PDA.

Objective:

To determine whether LUS score correlates with hemodynamic significance of PDA.

Design/Methods:

VLBWI with gestational ages below 32 weeks admitted to our institution between September 2021 and November 2022 were prospectively included in this observational study. Echocardiogram was performed on days of life 1,2 and 7 and LUS on days 3-14. PDA was considered hemodynamically significant (hs-PDA) when ductal size was ≧1.5 mm with a modified shunt volume score ≧5 (table 1). Pulmonary damage was graded from 0 to 18 according to Brat et al LUS score, after scanning anterior, lateral and posterior areas.

Results: 38 patients were enrolled with a median gestational age of 26.5 weeks (IQR 26-27.8) and birthweight of 950 g (IQR 852.5-1100). 8 (21%) were diagnosed with hs-PDA in the first week of life according to shunt volume score. A positive linear correlation was found between the shunt volume score and the LUS score (figure 1). LUS score was higher in patients with hs-PDA (mean (SD) 10.7 (3,2) vs 8.2 (3.1), p 0.02) (figure 2). None of the echocardiographic parameters of ductal size, pulmonary overcirculation and/or systemic hypoperfusion correlated independently with LUS score, except for left ventricular output on the 7th day of life (R²=0.1583; y=0,02x + 4,0397. p=0.03).

Conclusion(s): LUS score has a positive correlation with the hemodynamic significance of PDA, probably reflecting pulmonary overcirculation. Further studies are needed to investigate the role of LUS as a complementary tool to evaluate the clinical relevance of PDA in VLBWI.