Dx of PDA by Neonatologists

Dx of PDA by Neonatologists

Lee HC, Silverman N, and Hintz SR. Diagnosis of patent ductus arteriosus by a neonatologist with a compact, portable ultrasound machine. J Perinatol. 2007 May; 27(5):291-6. Full Text | PDF

Objectives: To conduct a pilot study assessing a neonatologist's accuracy in diagnosing patent ductus arteriosus (PDA) using compact, portable ultrasound after limited training.

Study design: Prospective study of premature infants scheduled for echocardiography for suspected PDA. A neonatologist with limited training performed study exams before scheduled exams. Sensitivity and specificity were calculated, compared to the scheduled echocardiogram interpreted by a cardiologist.

Results: There were 24 exams. Compared to the scheduled exam, the neonatologist's exam had sensitivity 69% (95% confidence interval (CI), 41 to 89%) and specificity 88% (95% CI, 47 to 99%). When a cardiologist interpreted the study exams, the sensitivity was 87% (95% CI, 60 to 98%) and specificity 71% (95% CI, 29 to 96%).

Conclusion: A neonatologist with limited training was able to detect PDA with moderate success. A more rigorous training process or real-time transmission with cardiologist interpretation may substantially improve accuracy. Institutions with experienced technicians and on-site pediatric cardiologists may not gain from intensive training of neonatologists, but hospitals where diagnosis and treatment of PDA would be delayed may benefit from such processes.

Comments. I am in agreement with the conclusions of this article. Neonatologists should be able to diagnose PDA with portable ultrasound machines. As technology advances everyday, there are very good portable machines that are avaialble and easy to use. In hospitals where we don’t have pediatric cardiologists, a neonatologist should be trained to do this to avoid delays in diagnosis. More complex heart diseases should be confirmed by a cardiologist. JMK

You may add your own comments to the discussion of this topic by selecting : Submit Comments.

Return to top

Hit Counter