Neonatologist-Performed Echocardiography versus Pediatric Cardiologist for the Patent Ductus Arteriosus in Preterm Newborns

新生儿科医生进行的心脏超声检查与儿科心脏病专家进行的心脏超声检查在早产儿动脉导管未闭诊断中的比较

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Abstract

Objective: Premature babies have a fragile circulatory system balance; therefore, rapid inter- vention may be needed in patients with patent ductus arteriosus (PDA). Echocardiography performed by a neonatologist can help to choose the best treatment option for newborns in a timely manner. The aim is to evaluate the performance of neonatologists in ductus assessment. Materials and Methods: Among the neonates born at the hospital, those diagnosed with PDA (n=40) under 32 weeks of gestational age were evaluated with echocardiography by a neo- natologist and a pediatric cardiologist. Interobserver variability analysis was done using the intraclass coefficient value and Cohen's kappa test results. Results: An excellent interobserver agreement was found in the peak systolic-to-end diastolic flow velocity ratio, a good agreement in the narrowest diameter of the ductus, peak systolic and diastolic velocities, and mitral A velocity. Raters had moderate to poor agreement in the rest of the variables such as left atrium/aorta ratio, ampulla diameter, length of the ductus, and left pulmonary artery diameter. Conclusion: It is suggested that neonatologists perform echocardiography to measure the nar- rowest diameter of the ductus and ductal flow velocities for PDA evaluation.

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