الفهرس 
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Abstract
PDA in preterm neonates causes significant clinical sequelae as a result from left to right shunting. It is widely recognized that a hemodynamically significant PDA is known to contribute to increased morbidity and mortality. The increase in pulmonary blood flow in the setting of prematurity leads to pulmonary edema, noncompliant lungs, and worsening of respiratory status. Other sequelae of a hemodynamically significant PDA include intraventricular hemorrhage, necrotizing enterocolitis, congestive heart failure, and failure to thrive. This study aimed to evaluate of the hemodynamic status and cardiac performance in preterm neonates with hs-PDA on HFOV and the conventional mechanical ventilation before and after closure of PDA. This prospective cohort study was conducted on 60 preterm neonates with left-to-right patent ductus arteriosus at NICU, Pediatric Department, Tanta University Hospital. The patients were subdivided into 2 main groups: • group 1: 30 Preterm neonates with hs-PDA on HFOV. • group 2: 30 Preterm neonates with hs-PDA on CMV of matched gestational age, sex and weight. Neonates with major congenital anomalies, dysrhythmia, chest deformities, IDM, congenital heart disease other than a patent foreman ovale or a small atrial septal defect, sepsis cases, hydrops fetalis and Neonates with sever intraventricular hemorrhage were excluded from the study. Echocardiography examinations, cardiometry and transracial US were performed before ventilation with the diagnosis of hs-PDA and at 1st, 3rd and 7th days of starting ventilation and we excluded any case with PDA which not closed at day 7 (not respond to treatment).