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145 RELATIONSHIP OF INTRAVASCULAR ARTERIAL PULSE PRESSURE (PP) AND SYMPTOMATIC PDA IN VLBW INFANTS

To study the relationship between intravascular arterial PP and the development of symptomatic PDA in VLBW infants (BW <1500 gm), 13 preterm neonates (m GA 27.5 wks range 25-31 wks, m BW 975 gms range 560-1360) were systematically and continuously monitored in terms of, (1) the onset of diuresis, (2) changes in FiO2, (3) x-ray evidence of increased pulmonary flow, (4) continuous arterial PP (determined via UA or radial line), (5) pulse pressure/systolic BP ratio (PP/SBP), (6) daily LA/AO ratio and (7) characteristic PDA murmur. Seven patients developed symptomatic PDA which is defined as the combination of aforementioned items 3, 7, and LA/AO ratio of >1.2. Retrospective analysis of PP (mmHg) in 7 symptomatic (sym) and 6 asymptomatic (asym) infants revealed the following:From 7th day on, PP between the two groups became significantly different and PP/SBP ratio exceeding 48% in symptomatic infants. All infants who had PP of 22 mmHg or more before 7th day went on to develop full blown symptomatic PDA. None of the asymptomatic infants had PP exceeded 22 mmHg during the study period. We conclude that PP of >22 mmHg during the first 7 days of life is a good predictor of sym development of PDA in VLBW infants.