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Correspondence: “Patent ductus arteriosus shunt elimination results in a reduction in adverse outcomes: a post hoc analysis of the PDA RCT cohort”

Journal of Perinatology volume 42, page 692 (2022)Cite this article

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We read with interest the recent publications by El-Khuffash et al [1,2,3] on the management of patent ductus arteriosus (PDA) in preterm infants. There is good evidence that aggressive prevention or treatment of PDAs does not reduce the risk of chronic lung disease (CLD) [4,5,6]. However, many clinicians have experienced dramatically improved respiratory status in some infants after PDA closure and it is likely that a small sub-group of preterm infants with PDAs do benefit from more aggressive treatment.

The question remains how to identify such infants. The authors address this issue by developing a “PDA severity score” (PDASC) that uses gestational age and four echocardiogram parameters to predict CLD or death in preterm infants with PDAs [2]. We are confused as to why this is considered a measure of PDA severity as there is little evidence that PDAs are causal factors in CLD, rather than just being associations (smaller and sicker infants are more likely to have PDAs, are also more likely to have CLD). We suggest the score is better considered a CLD prediction score (CLDPS), albeit one that only works in infants with PDAs.

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References

  1. Bussmann N, Smith A, Breatnach CR, McCallion N, Cleary B, Franklin O, et al. Patent ductus arteriosus shunt elimination results in a reduction in adverse outcomes: a post hoc analysis of the PDA RCT cohort. J Perinatol. 2021;41:1134–41.

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  2. El-Khuffash A, James AT, Corcoran JD, Dicker P, Franklin O, Elsayed YN, et al. A patent ductus arteriosus severity score predicts chronic lung disease or death before discharge. J Pediatr. 2015;167:1354–61. e1352

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Authors and Affiliations

  1. Morristown Medical Center, Atlantic Health System, 100 Madison Avenue, Morristown, NJ, 07960, USA

    Naureen Memon & Ian Griffin

  2. MidAtlantic Neonatal Associates, 100 Madison Ave., Morristown, NJ, 07960, USA

    Naureen Memon & Ian Griffin

  3. Biomedical Research Institute of New Jersey, 140 E. Hanover Ave, Cedar Knolls, Hanover, NJ, 07927, USA

    Naureen Memon & Ian Griffin

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  1. Naureen Memon
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Both authors contributed to writing the correspondence.

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Correspondence to Ian Griffin.

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Memon, N., Griffin, I. Correspondence: “Patent ductus arteriosus shunt elimination results in a reduction in adverse outcomes: a post hoc analysis of the PDA RCT cohort”. J Perinatol 42, 692 (2022). https://doi.org/10.1038/s41372-021-01234-z

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