63 Bronchopulmonary dysplasia, IGF-I & nutrition 3 Patent ductus arteriosus was defined as a patent ductus on ultrasound which was treated with medication or required surgical intervention. Treatment was considered when an infant had respiratory distress, a patent ductus with left-right shunting and: • 3 characteristics of a moderate left-right shunting with a duct diameter of at least 1.6 mm and a pulsatile flow pattern OR • 2 characteristics of a large left-right shunt and a duct diameter of at least 2 mm and a pulsatile flow pattern Small left-right shunt Moderate left-right shunt Large left-right shunt Diameter of the ductus arteriosus (mm) < 1.6 1.6 – 2.0 > 2.0 Flow pattern in the ductus arteriosus Closing Growing/pulsatile Pulsatile End diastolic flow in left pulmonary artery (m/s) < 0.20 0.20 – 0.40 > 0.40 Flow in the aorta descendens Antegrade flow No or minimally reversed flow Reversed flow Flow speed in ductus arteriosus > 2.0 1.0 – 2.0 < 1.0 Left atrial to aortic root ration < 1.4 1.4 – 1.6 > 1.6 Source: local protocol Amsterdam University Medical Centers Neonatal Intensive Care Unit
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