Noninvasive technique for the diagnosis of patent ductus arteriosus in premature infants by analyzing pulse wave phases on photoplethysmography signals measured in the right hand and the left foot.

OBJECTIVE: To evaluate the impact of patent ductus arteriosus (PDA) on the pulse phase difference (PPD) between the left foot (postductal region) and the right hand (preductal region). MATERIALS AND METHODS: PPD was determined from arterial photoplethysmography signals (pulse waves) measured by infr...

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Main Authors: Sabrina Goudjil, Fatiha Imestouren, Aurelie Armougon, Lucie Razafimanantsoa, Mahdi Mahmoudzadeh, Fabrice Wallois, André Leke, Guy Kongolo
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2014-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC4043784?pdf=render
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author Sabrina Goudjil
Fatiha Imestouren
Aurelie Armougon
Lucie Razafimanantsoa
Mahdi Mahmoudzadeh
Fabrice Wallois
André Leke
Guy Kongolo
author_facet Sabrina Goudjil
Fatiha Imestouren
Aurelie Armougon
Lucie Razafimanantsoa
Mahdi Mahmoudzadeh
Fabrice Wallois
André Leke
Guy Kongolo
author_sort Sabrina Goudjil
collection DOAJ
description OBJECTIVE: To evaluate the impact of patent ductus arteriosus (PDA) on the pulse phase difference (PPD) between the left foot (postductal region) and the right hand (preductal region). MATERIALS AND METHODS: PPD was determined from arterial photoplethysmography signals (pulse waves) measured by infrared sensors routinely used for pulse oximetry in 56 premature infants less than 32 weeks gestation. Only infants with significant PDA (sPDA) diagnosed by echocardiography were treated with ibuprofen (for 3 days). Patients were classified according to whether or not they responded (Success/Failure) to this treatment. The Control group was composed of infants in whom ductus had already closed spontaneously at the time of the first echocardiography. The 3 groups were compared in terms of PPD at the beginning (T1) and at the end (T2) of the study. For patients in the Failure (n = 17) and Success groups (n = 18), T1 corresponded to the first day of treatment and T2 to the day after completion of the course of ibuprofen. In the Control group (n = 21), T1 corresponded to 1 to 3 days of life (DOL), and T2 to 4-6 DOL. RESULTS: Compared to the Control group, PPD was higher in the Failure (at T1 and T2) and Success (at T1) groups characterized by sPDA. After ibuprofen therapy, PPD in the Success group decreased to about the level observed in the Control group. The area under the ROC curve of PPD for the diagnosis of sPDA was 0.98 (95% CI 0.96-1); for an optimal cut-off of PPD ≥ 1.65 deg/cm, the sensitivity was 94.2% and the specificity was 98.3%. CONCLUSION: In this study, PPD was correlated with ductus arteriosus status evaluated by echocardiography, indicating involvement of the ductal shunt in the mechanism of redistribution in systemic vascular territories. PPD can be considered for the diagnosis of hemodynamically significant PDA.
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spelling doaj.art-f57aafcec4414a4db80f718805288fca2022-12-22T01:15:05ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-0196e9876310.1371/journal.pone.0098763Noninvasive technique for the diagnosis of patent ductus arteriosus in premature infants by analyzing pulse wave phases on photoplethysmography signals measured in the right hand and the left foot.Sabrina GoudjilFatiha ImestourenAurelie ArmougonLucie RazafimanantsoaMahdi MahmoudzadehFabrice WalloisAndré LekeGuy KongoloOBJECTIVE: To evaluate the impact of patent ductus arteriosus (PDA) on the pulse phase difference (PPD) between the left foot (postductal region) and the right hand (preductal region). MATERIALS AND METHODS: PPD was determined from arterial photoplethysmography signals (pulse waves) measured by infrared sensors routinely used for pulse oximetry in 56 premature infants less than 32 weeks gestation. Only infants with significant PDA (sPDA) diagnosed by echocardiography were treated with ibuprofen (for 3 days). Patients were classified according to whether or not they responded (Success/Failure) to this treatment. The Control group was composed of infants in whom ductus had already closed spontaneously at the time of the first echocardiography. The 3 groups were compared in terms of PPD at the beginning (T1) and at the end (T2) of the study. For patients in the Failure (n = 17) and Success groups (n = 18), T1 corresponded to the first day of treatment and T2 to the day after completion of the course of ibuprofen. In the Control group (n = 21), T1 corresponded to 1 to 3 days of life (DOL), and T2 to 4-6 DOL. RESULTS: Compared to the Control group, PPD was higher in the Failure (at T1 and T2) and Success (at T1) groups characterized by sPDA. After ibuprofen therapy, PPD in the Success group decreased to about the level observed in the Control group. The area under the ROC curve of PPD for the diagnosis of sPDA was 0.98 (95% CI 0.96-1); for an optimal cut-off of PPD ≥ 1.65 deg/cm, the sensitivity was 94.2% and the specificity was 98.3%. CONCLUSION: In this study, PPD was correlated with ductus arteriosus status evaluated by echocardiography, indicating involvement of the ductal shunt in the mechanism of redistribution in systemic vascular territories. PPD can be considered for the diagnosis of hemodynamically significant PDA.http://europepmc.org/articles/PMC4043784?pdf=render
spellingShingle Sabrina Goudjil
Fatiha Imestouren
Aurelie Armougon
Lucie Razafimanantsoa
Mahdi Mahmoudzadeh
Fabrice Wallois
André Leke
Guy Kongolo
Noninvasive technique for the diagnosis of patent ductus arteriosus in premature infants by analyzing pulse wave phases on photoplethysmography signals measured in the right hand and the left foot.
PLoS ONE
title Noninvasive technique for the diagnosis of patent ductus arteriosus in premature infants by analyzing pulse wave phases on photoplethysmography signals measured in the right hand and the left foot.
title_full Noninvasive technique for the diagnosis of patent ductus arteriosus in premature infants by analyzing pulse wave phases on photoplethysmography signals measured in the right hand and the left foot.
title_fullStr Noninvasive technique for the diagnosis of patent ductus arteriosus in premature infants by analyzing pulse wave phases on photoplethysmography signals measured in the right hand and the left foot.
title_full_unstemmed Noninvasive technique for the diagnosis of patent ductus arteriosus in premature infants by analyzing pulse wave phases on photoplethysmography signals measured in the right hand and the left foot.
title_short Noninvasive technique for the diagnosis of patent ductus arteriosus in premature infants by analyzing pulse wave phases on photoplethysmography signals measured in the right hand and the left foot.
title_sort noninvasive technique for the diagnosis of patent ductus arteriosus in premature infants by analyzing pulse wave phases on photoplethysmography signals measured in the right hand and the left foot
url http://europepmc.org/articles/PMC4043784?pdf=render
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