J. Koch, G. Hensley, L. Roy, S. Brown, C. Ramaciotti et al., Prevalence of Spontaneous Closure of the Ductus Arteriosus in Neonates at a Birth Weight of 1000 Grams or Less, Pediatrics, vol.117, issue.4, pp.1113-1121, 2006.

M. Kluckow, The Pathophysiology of Low Systemic Blood Flow in the Preterm Infant, Front. Pediatr, vol.6, p.29, 2018.

M. Gillam-krakauer and J. Reese, Diagnosis and Management of Patent Ductus Arteriosus, NeoReviews, vol.19, issue.7, pp.394-402, 2018.

S. , 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, vol.9, issue.6, p.98763, 2014.

, Embryologie médicale par

T. W. Sadler, Pradel Editions 9782913996120 -medimops, p.26, 2019.

A. C. Gittenberger-de-groot, I. Van-ertbruggen, A. J. Moulaert, and E. Harinck, The ductus arteriosus in the preterm infant: histologic and clinical observations, J. Pediatr, vol.96, issue.1, pp.88-93, 1980.

T. Hundscheid, M. Van-den-broek, R. Van-der-lee, and W. P. De-boode, Understanding the pathobiology in patent ductus arteriosus in prematurity-beyond prostaglandins and oxygen, Pediatr. Res, vol.86, issue.1, p.28, 2019.

, Molecular Mechanisms for Regulating Postnatal Ductus Arteriosus Closure

S. L. Crockett, C. D. Berger, E. L. Shelton, and J. Reese, Molecular and mechanical factors contributing to ductus arteriosus patency and closure, Congenit. Heart Dis, vol.14, issue.1, pp.15-20, 2019.

F. Coceani and P. M. Olley, The response of the ductus arteriosus to prostaglandins, Can. J. Physiol. Pharmacol, vol.51, issue.3, pp.220-225, 1973.

V. Gournay, The ductus arteriosus: physiology, regulation, and functional and congenital anomalies, Arch. Cardiovasc. Dis, vol.104, issue.11, pp.578-585, 2011.

D. J. Schneider, The Patent Ductus Arteriosus in Term Infants, Children, and Adults, Semin. Perinatol, vol.36, issue.2, pp.146-153, 2012.

M. Obladen, History of the Ductus Arteriosus: 1. Anatomy and Spontaneous Closure, Neonatology, vol.99, issue.2, pp.83-89, 2011.

W. Nahid, Prostaglandin E2-Mediated Relaxation of the Ductus Arteriosus, Circulation, vol.110, issue.16, pp.2326-2332, 2004.

Y. N. Elsayed and D. Fraser, Patent Ductus Arteriosus in Preterm Infants, Part 1: Understanding the Pathophysiologic Link Between the Patent Ductus Arteriosus and Clinical Complications, Neonatal Netw. NN, vol.36, issue.5, pp.265-272, 2017.

W. E. Benitz, Patent ductus arteriosus: to treat or not to treat?, Arch. Dis. Child. Fetal Neonatal Ed, vol.97, issue.2, pp.80-82, 2012.

H. W. Park, Y. Choi, K. S. Kim, and S. Kim, Chorioamnionitis and Patent Ductus Arteriosus: A Systematic Review and Meta-Analysis, PloS One, vol.10, issue.9, p.138114, 2015.

E. F. Bell, D. Warburton, B. S. Stonestreet, and W. Oh, Effect of fluid administration on the development of symptomatic patent ductus arteriosus and congestive heart failure in premature infants, N. Engl. J. Med, vol.302, issue.11, pp.598-604, 1980.

V. V. Kulkarni, S. Dutta, V. Sundaram, and S. S. Saini, Preterm Thrombocytopenia and Delay of Ductus Arteriosus Closure, Pediatrics, vol.138, issue.4, 2016.

X. Durrmeyer, Are cytochrome P450 CYP2C8 and CYP2C9 polymorphisms associated with ibuprofen response in very preterm infants?, PloS One, vol.5, issue.8, p.12329, 2010.

R. I. Clyman, Mechanisms regulating the ductus arteriosus, Biol. Neonate, vol.89, issue.4, pp.330-335, 2006.

S. Shimada, T. Kasai, M. Konishi, and T. Fujiwara, Effects of patent ductus arteriosus on left ventricular output and organ blood flows in preterm infants with respiratory distress syndrome treated with surfactant, J. Pediatr, vol.125, issue.2, pp.270-277, 1994.

R. I. Clyman, J. Couto, and G. M. Murphy, Patent ductus arteriosus: are current neonatal treatment options better or worse than no treatment at all?, Semin. Perinatol, vol.36, issue.2, pp.123-129, 2012.

W. E. Benitz, Treatment of persistent patent ductus arteriosus in preterm infants: time to accept the null hypothesis?, J. Perinatol. Off. J. Calif. Perinat. Assoc, vol.30, issue.4, pp.241-252, 2010.

R. I. Clyman, The role of patent ductus arteriosus and its treatments in the development of bronchopulmonary dysplasia, Semin. Perinatol, vol.37, issue.2, pp.102-107, 2013.

D. E. Weisz, K. More, P. J. Mcnamara, and P. S. Shah, PDA ligation and health outcomes: a meta-analysis, Pediatrics, vol.133, issue.4, pp.1024-1046, 2014.

U. Kessler, Outcome in neonates with necrotizing enterocolitis and patent ductus arteriosus, World J. Pediatr. WJP, vol.12, issue.1, pp.55-59, 2016.

L. Mirea, Treatment of patent ductus arteriosus and neonatal mortality/morbidities: adjustment for treatment selection bias, J. Pediatr, vol.161, issue.4, pp.689-694, 2012.

H. E. Momtaz, M. K. Sabzehei, B. Rasuli, and S. Torabian, The main etiologies of acute kidney injury in the newborns hospitalized in the neonatal intensive care unit, J. Clin. Neonatol, vol.3, issue.2, pp.99-102, 2014.

E. J. Kort, Patent Ductus Arteriosus in the Preterm Infant: An Update on Morbidity and Mortality, Curr. Pediatr. Rev, vol.12, issue.2, pp.98-105, 2016.

M. Kluckow and P. Lemmers, Hemodynamic assessment of the patent ductus arteriosus: Beyond ultrasound, Semin. Fetal. Neonatal Med, vol.23, issue.4, pp.239-244, 2018.

N. Evans and J. Moorcraft, Effect of patency of the ductus arteriosus on blood pressure in very preterm infants, Arch. Dis. Child, vol.67, issue.10, pp.1169-1173, 1992.

S. Alagarsamy, M. Chhabra, M. Gudavalli, A. M. Nadroo, V. G. Sutija et al., Comparison of clinical criteria with echocardiographic findings in diagnosing PDA in preterm infants, J. Perinat. Med, vol.33, issue.2, pp.161-164, 2005.

P. Davis, S. Turner-gomes, K. Cunningham, C. Way, R. Roberts et al., Precision and accuracy of clinical and radiological signs in premature infants at risk of patent ductus arteriosus, Arch. Pediatr. Adolesc. Med, vol.149, issue.10, pp.1136-1141, 1995.

D. Van-laere, Application of NPE in the assessment of a patent ductus arteriosus, Pediatr. Res, vol.84, pp.46-56, 2018.

D. Van-laere, Application of NPE in the assessment of a patent ductus arteriosus, Pediatr. Res, vol.84, pp.46-56, 2018.

M. Kluckow and N. Evans, Early echocardiographic prediction of symptomatic patent ductus arteriosus in preterm infants undergoing mechanical ventilation, J. Pediatr, vol.127, issue.5, pp.774-779, 1995.

T. Nishikimi, N. Maeda, and H. Matsuoka, The role of natriuretic peptides in cardioprotection, Cardiovasc. Res, vol.69, issue.2, pp.318-328, 2006.

M. Kavga, Correlation of plasma B-type natriuretic peptide with shunt volume in children with congenital heart disease involving left-to-right shunt, Hell. J. Cardiol. HJC Hell. Kardiologike Epitheorese, vol.54, issue.3, pp.192-198, 2013.

K. Mine, A. Ohashi, S. Tsuji, J. Nakashima, M. Hirabayashi et al., B-type natriuretic peptide for assessment of haemodynamically significant patent ductus arteriosus in premature infants, Acta Paediatr. Oslo Nor, vol.102, issue.8, pp.347-352, 1992.

D. Trevisanuto, Effect of patent ductus arteriosus and indomethacin treatment on serum cardiac troponin T levels in preterm infants with respiratory distress syndrome, Eur. J. Pediatr, vol.159, issue.4, pp.273-276, 2000.

J. M. Perlman, A. Hill, and J. J. Volpe, The effect of patent ductus arteriosus on flow velocity in the anterior cerebral arteries: ductal steal in the premature newborn infant, J. Pediatr, vol.99, issue.5, pp.767-771, 1981.

C. Kupferschmid, D. Lang, and F. Pohlandt, Sensitivity, specificity and predictive value of clinical findings, m-mode echocardiography and continuous-wave Doppler sonography in the diagnosis of symptomatic patent ductus arteriosus in preterm infants, Eur. J. Pediatr, vol.147, issue.3, pp.279-282, 1988.

J. J. Wang and K. H. Parker, Wave propagation in a model of the arterial circulation, J. Biomech, vol.37, issue.4, pp.457-470, 2004.

S. A. Hoodbhoy, H. A. Cutting, J. A. Seddon, and M. E. Campbell, Cerebral and splanchnic hemodynamics after duct ligation in very low birth weight infants, J. Pediatr, vol.154, issue.2, pp.196-200, 2009.

K. M. Broadhouse, Cardiovascular magnetic resonance of cardiac function and myocardial mass in preterm infants: a preliminary study of the impact of patent ductus arteriosus, J. Cardiovasc. Magn. Reson. Off. J. Soc. Cardiovasc. Magn. Reson, vol.16, p.54, 2014.

S. I. Sung, Mandatory Closure Versus Nonintervention for Patent Ductus Arteriosus in Very Preterm Infants, J. Pediatr, vol.177, pp.66-71, 2016.

S. Mitra, Association of Placebo, Indomethacin, Ibuprofen, and Acetaminophen With Closure of Hemodynamically Significant Patent Ductus Arteriosus in Preterm Infants: A Systematic Review and Meta-analysis, JAMA, vol.319, issue.12, pp.1221-1238, 2018.

B. Van-overmeire, A comparison of ibuprofen and indomethacin for closure of patent ductus arteriosus, N. Engl. J. Med, vol.343, issue.10, pp.674-681, 2000.

S. Godambe, B. Newby, V. Shah, and P. S. Shah, Effect of indomethacin on closure of ductus arteriosus in very-low-birthweight neonates, Acta Paediatr. Oslo Nor, vol.95, issue.11, pp.1389-1393, 1992.

V. S. Rajadurai and V. Y. Yu, Intravenous indomethacin therapy in preterm neonates with patent ductus arteriosus, J. Paediatr. Child Health, vol.27, issue.6, pp.370-375, 1991.

A. Ohlsson, R. Walia, and S. S. Shah, Ibuprofen for the treatment of patent ductus arteriosus in preterm or low birth weight (or both) infants, Cochrane Database Syst. Rev, issue.2, p.3481, 2015.

C. Hammerman, A. Bin-nun, E. Markovitch, M. S. Schimmel, M. Kaplan et al., Ductal closure with paracetamol: a surprising new approach to patent ductus arteriosus treatment, Pediatrics, vol.128, issue.6, pp.1618-1621, 2011.

A. El-khuffash, Efficacy of paracetamol on patent ductus arteriosus closure may be dose dependent: evidence from human and murine studies, Pediatr. Res, vol.76, issue.3, pp.238-244, 2014.

G. Terrin, Paracetamol for the treatment of patent ductus arteriosus in preterm neonates: a systematic review and meta-analysis, Arch. Dis. Child. Fetal Neonatal Ed, vol.101, issue.2, pp.127-136, 2016.

R. Neumann, S. M. Schulzke, and C. Bührer, Oral Ibuprofen versus Intravenous Ibuprofen or Intravenous Indomethacin for the Treatment of Patent Ductus Arteriosus in Preterm Infants: A Systematic Review and Meta-Analysis, Neonatology, vol.102, issue.1, pp.9-15, 2012.

R. E. Gross and J. P. Hubbard, Surgical Ligation of a Patent Ductus Arteriosus: Report of First Successful Case, JAMA, vol.251, issue.9, pp.1201-1202, 1984.

M. H. Ibrahim, Outcomes of Early Ligation of Patent Ductus Arteriosus in Preterms, Multicenter Experience, Medicine (Baltimore), vol.94, issue.25, p.915, 2015.

N. Evans, Diagnosis of patent ductus arteriosus in the preterm newborn, Arch. Dis. Child, vol.68, issue.1, pp.58-61, 1993.

G. Cassady, A randomized, controlled trial of very early prophylactic ligation of the ductus arteriosus in babies who weighed 1000 g or less at birth, N. Engl. J. Med, vol.320, issue.23, pp.1511-1516, 1989.

F. Roubertie, D. Kalfa, M. Lenoir, and E. L. Bret, Persistance du canal artériel, p.16, 2019.

D. Kalfa, G. Krishnamurthy, and E. Cheung, Patent ductus arteriosus surgical ligation: Still a lot to understand, J. Thorac. Cardiovasc. Surg, vol.152, issue.2, pp.505-506, 2016.

P. Mandhan, S. Brown, A. Kukkady, and U. Samarakkody, Surgical closure of patent ductus arteriosus in preterm low birth weight infants, Congenit. Heart Dis, vol.4, issue.1, pp.34-37, 2009.

P. Valentík, I. Omeje, R. Poruban, M. ?agát, and M. Nosál, Surgical closure of patent ductus arteriosus in pre-term babies, Images Paediatr. Cardiol, vol.9, issue.2, pp.27-36, 2007.

D. E. Weisz, K. More, P. J. Mcnamara, and P. S. Shah, PDA Ligation and Health Outcomes: A Meta-analysis, Pediatrics, vol.133, issue.4, pp.1024-1046, 2014.

D. E. Weisz, Association of Patent Ductus Arteriosus Ligation With Death or Neurodevelopmental Impairment Among Extremely Preterm Infants, JAMA Pediatr, vol.171, issue.5, pp.443-449, 2017.

D. E. Weisz, Outcomes of Surgical Ligation after Unsuccessful Pharmacotherapy for Patent Ductus Arteriosus in Neonates Born Extremely Preterm, J. Pediatr, vol.195, pp.292-296, 2018.

K. E. Sørensen, B. Kristensen, and O. K. Hansen, Frequency of occurrence of residual ductal flow after surgical ligation by color-flow mapping, Am. J. Cardiol, vol.67, issue.7, pp.653-654, 1991.

H. Halil, M. Buyuktiryaki, F. Y. Atay, M. Y. Oncel, and N. Uras, Reopening of the ductus arteriosus in preterm infants; Clinical aspects and subsequent consequences, J. Neonatal-Perinat. Med, vol.11, issue.3, pp.273-279, 2018.

H. Weiss, B. Cooper, M. Brook, M. Schlueter, and R. Clyman, Factors determining reopening of the ductus arteriosus after successful clinical closure with indomethacin, J. Pediatr, vol.127, issue.3, pp.466-471, 1995.

D. Quinn, B. Cooper, and R. I. Clyman, Factors associated with permanent closure of the ductus arteriosus: a role for prolonged indomethacin therapy, Pediatrics, vol.110, issue.1, 2002.

P. M. Lemmers, M. C. Molenschot, J. Evens, M. C. Toet, and F. Van-bel, Is cerebral oxygen supply compromised in preterm infants undergoing surgical closure for patent ductus arteriosus?, Arch. Dis. Child. Fetal Neonatal Ed, vol.95, issue.6, pp.429-434, 2010.

M. E. Hajjar, G. Vaksmann, T. Rakza, G. Kongolo, and L. Storme, Severity of the ductal shunt: a comparison of different markers, Arch. Dis. Child. Fetal Neonatal Ed, vol.90, issue.5, pp.419-422, 2005.

F. De-freitas and . Martins, Relationship of Patent Ductus Arteriosus Size to Echocardiographic Markers of Shunt Volume, J. Pediatr, vol.202, pp.50-55, 2018.

, La classification de Papile est une classification radiologique des HIV basée sur le scanner

, Les HIV sont classées en 4 stades : Stade 1 : l'hémorragie est localisée à la matrice germinative

, Stade 2 : l'hémorragie fait effraction dans le ventricule mais n'entraîne pas de dilatation ventriculaire

, Stade 3 : l'HIV entraîne une dilatation ventriculaire et le caillot s'étend sur plus de la moitié de la longueur du ventricule Stade 4 : l'HIV s'accompagne d'un

, Annexe 2

, ECUN Contribution of the analysis of the pulse wave to the evaluation criteria of the haemodynamic resonance of the ductus arteriosus in the premature infant under 32 weeks of amenorrhea Introduction: The persistent ductus arteriosus (DA) creates a vascular shunt between the aorta and the pulmonary artery. It is responsible for low systemic flow and pulmonary overload leading and is associated to morbidity and mortality. However, treatments used to close the DA are also at risk of complication

, Transthoracic ultrasound , the gold-standard technique for the diagnosis of DA and the severity of the ductal shunt, is criticized because of the weakness of the correlations between its results and clinical manifestations and evolution of those preterm babies. New severity markers such as Brain Natriuric Peptide (BNP) assay and pre-and post-ductal pulse wave phase difference (PPD) analysis have been developed

, Objective: To compare the Hilbert-Huang transform (HH) and the Poincaré stroboscopic techniques for the estimation of PPD used for evaluation of DA

, 20 preterm infants hospitalized at Amiens University Hospital were included, the median term at birth was 28 weeks, 2010.

, The estimate of the cross-correlation (CC) pulse propagation time gradient was 19.8% [14.9-25] of the cardiac cycle time. The PPD results obtained by the HH and Poincaré techniques showed a significant positive relationship (angular coefficient 0.69, r2 = 0.56, p <0.001). The relationship between PPD by the HH technique and the hemodynamic severity index by CC was also positive and significant

, The reproducibility of the Poincaré and CC techniques was satisfactory. There is good reproducibility of the measurements of these two techniques. These non-invasive techniques could be integrated into a multimodal analysis of arterial duct resonance, Conclusion: Our results suggest a good correlation between HH and Poincaré and CC techniques

, Key words: persistent ductus arteriosus, pulse wave phase difference (PPD), prematurity, Poincaré transformation

, canal artériel chez le prématuré de moins de 32 semaines d'aménorrhée Introduction: Le canal artériel (CA) persistant réalise un shunt vasculaire entre l'aorte et l'artère pulmonaire responsable d'un bas débit systémique et d'une surcharge pulmonaire à l'origine de la morbi-mortalité associée; cependant les traitements utilisés pour traiter le CA sont aussi à risque de complication, ce qui nécessite d'établir à chaque fois un rapport bénéfice/risque en faveur de la sécurité de l'enfant. L'échographie trans-thoracique (ETT), technique de référence pour le diagnostic du CA et la sévérité du shunt ductal, est critiquée du fait des corrélations faibles avec les manifestations cliniques et l'évolution. De nouveaux marqueurs de sévérité tels que le dosage du Brain Natriuretique Peptide (BNP) et l'analyse de la différence de phase de l

. Objectif, Comparer les techniques procédant par la transformée de Hilbert-Huang (HH) et la technique stroboscopique de Poincaré pour l

, 20 prématurés hospitalisés au CHU d'Amiens ont été inclus, le terme médian à la naissance était de 28 SA, Résultats: entre janvier 2010 et Juillet, 2013.

, Chez 5 patients, la chirurgie était nécessaire après échec de traitement par ibuprofène. Selon la technique de Poincaré, la valeur de PPD était de1

, La reproductibilité était satisfaisante avec un coefficient de variation de 10

, Les résultats de PPD obtenus par la technique HH et par Poincaré présentaient une relation positive significative

, La relation entre PPD par la technique HH et l'index de sévérité hémodynamique par CC était également positive et significative

, Conclusion: Nos résultats montrent une corrélation entre HH et les techniques : Poincaré et CC. La reproductibilité des techniques de Poincaré et de CC était satisfaisante. Il existe une reproductibilité des mesures de ces deux techniques. Ces techniques non invasives pourraient s'

, Mots clés: canal artériel perméable, différence de phase de l'onde de pouls (PPD), prématurité, transformation de Poincaré