ABSTRACT
It is not known at which size a congenital Patent ductus arteriosus (PDA) in children becomes associated with a resultant severe malnutrition in children. Furthermore, the effect of ductal size on anthropometry of children with PDA is yet to be determined. Objectives This study was aimed to asses if the ductal size had any effect on anthropometry of children with PDA and at which size evidence of severe malnutrition ensues Methods This was a five-year observational cross-sectional study of children who presented at three tertiary institutions with PDA. Results There was a negative non-significant correlation between the size of PDA and the weight of patients, (Pearson correlation coefficient = -0.1, p = 0.7). There was also a negative non-significant correlation between the size of PDA and patient’s height/length, (correlation coefficient = -0.1, p = 0.5). The association between the size of PDA and the severity of malnutrition revealed greater proportion of 35.3% (6/17) for wasting and stunting in patients who had large PDA sizes of >7mm, when compared with fewer proportions in those with PDA sizes of 3- 6mm (26.1% (6/23) and those with tiny PDA of <3mm (33.3% (10/30); (?2 = 10.21, p = 0.8). There was a positive correlation between ductal size and nutritional status of patients, and severe malnutrition ensued from ductal size of 3.2mm; with ETA square of 0.072. The majority of children with PDA presented with severe forms of malnutrition (wasting and stunting). Conclusion: Severe malnutrition ensues when ductal size is 3.2mm. The size of PDA has no effect on weight and height of children with PDA.
ABSTRACT
PURPOSE: In the clinical field, the closing time of patent ductus arteriosus(PDA) varies among patients after indomethacin administration. We tried to predict it by analyzing related factors, and also by understanding what affects it. METHODS: Among 30 cases of PDA at the NICU, 24 cases(male 14 cases, female 10 cases) were selected. Fifteen cases closed early(within 36 hours) and 9 cases closed late(after 36 hours) after indomethacin administration, cases of surgical ligation were excluded. PDA was confirmed by echocardiography which was done in an hour after murmur was heard, and then indomethacin was administered. Every 6 hours, 2D echocardiography was done and minimum internal diameter of ductus was measured. The magnitude and direction were gauged by flow mapping of the color Doppler. Ductal closure time is defined when there is no ductal flow. RESULTS: The median of the patent time was 28 hours in the early closed group and 50 hours in the late closed group. There were no significant factors statistically between the two groups in perinatal factors. The clinical status and several factors of study population at indomethacin administration were also not significant. Whereas, there were statistical differences in ductal size between the two groups(P<0.05). CONCLUSION: When indomethacin is intravenously administered to treat the PDA, ductal size differed between the two groups. This ductal size, measured by echocardiography before indomethacin administration is an important factor in predicting the closing time of PDA.