Echocardiography in the care of the premature infant with patent ductus arteriosus.

Patient records of 235 premature infants with patent ductus arteriosus (PDA) were examined in a retrospective study. Patients admitted prior to the use of the echocardiogram for diagnosis of PDA were compared to patients admitted after the introduction of the test. Patients admitted after the use of the echocardiogram showed mortality improved from 0.355/PDA to 0.172/PDA. At the time of the introduction of the test, surgical ligation as a therapeutic measure dropped from 3.05/mothes to 0.85/month. Length of time from admission to discharge and admission to diagnosis declined. Mean cost per patient day decreased $14.13 in PDA patients. Infants who went to surgery showed birth weights decrease by 325.99 grams and time from diagnosis to surgical ligation increased by 6.89 days. Although causality may not be implied, there exists a strong association between the introduction of the echocardiogram and the quantification of the severity of the PDA, and in the improvements seen in these measures of the quality of care. It is concluded that echocardiography may have been influential in improving the physician's care of the premature infant with PDA.