Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Background: Over the past decade, much of what we thought we knew to be true regarding the PDA in the preterm neonate has been re-evaluated leading to new approaches to the clinical evaluation and treatment of the PDA. According to the degree of associated clinical symptoms and signs secondary to excessive blood flow to the lungs and impaired systemic and vital organs perfusion, PDA can be defined as a hemodynamically significant. Although previous studies have discussed the disturbance in cerebral blood flow as a result of PDA, yet very few studies have evaluated whether this disturbance in cerebral blood flow is sufficient to compromise cerebral function. Aim of the study: The aim of the present study is to evaluate the effects of the PDA on the cerebral blood flow and whether they are sufficiently enough to affect the cortical function of the preterm brain. Methodology: A prospective cross sectional study was carried out on fourty preterm infants with gestational age less than 36 weeks during their first week of postnatal age who were admitted to the neonatal intensive care unit at Cairo university specialized children hospital, divided into study group (20 preterm infants) having moderate to large sized PDA and control group (20 preterm infants) without PDA, with nostatistically significant difference between the 2 groups in the gestational and postnatal age. Clinical data collected including full clinical and neurological examination. Echocardiography was done to assess the PDA size, cranial ultrasound and transcranial doppler were done to assess the cerebral blood flow indices. Continuous EEG monitoring was performed bed side for at least 12 hours and the results were analysed using two previously published methods of aEEG interpretation

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