Managing the patent ductus arteriosus: current treatment options
- 5 June 2014
- journal article
- review article
- Published by BMJ in Archives of Disease in Childhood: Fetal & Neonatal
- Vol. 99 (5), F431-F436
- https://doi.org/10.1136/archdischild-2014-306176
Abstract
Optimal management of the patent ductus arteriosus (PDA) in the premature infant remains controversial. Despite considerable historical and physiological data indicating that a persistent PDA may be harmful, robust evidence of long-term benefits or harms from treatment is lacking. This has been equated to a lack of benefit but is also a reflection of the fact that most clinical trials were designed to assess the effects of short-term (2-8 days) rather than prolonged exposure to a PDA. No clinical trials have been designed to assess the effects of prolonged exposure of persistent PDA on morbidity and mortality of very premature infants in the era of antenatal corticosteroids, surfactant and non-invasive respiratory support. Further research is required, but new insights and novel therapies are evolving, which will allow greater individual patient assessment, understanding of risk and optimisation of treatment. In this paper, we review the current literature, evidence for treatment options, including a non-interventional approach, and research directions for infants <28 weeks' gestational age.Keywords
This publication has 52 references indexed in Scilit:
- Patent Ductus Arteriosus: Are Current Neonatal Treatment Options Better or Worse Than No Treatment at All?Seminars in Perinatology, 2012
- Patent Ductus Arteriosus Ligation Alters Pulmonary Gene Expression in Preterm BaboonsPediatric Research, 2011
- Early Surgical Ligation Versus a Conservative Approach for Management of Patent Ductus Arteriosus That Fails to Close after Indomethacin TreatmentThe Journal of Pediatrics, 2010
- Patent Ductus Arteriosus Therapy: Impact on Neonatal and 18-Month OutcomePediatrics, 2009
- Towards rational management of the patent ductus arteriosus: the need for disease stagingArchives of Disease in Childhood: Fetal & Neonatal, 2007
- Patent ductus arteriosus: lack of evidence for common treatmentsArchives of Disease in Childhood: Fetal & Neonatal, 2007
- Catheter closure of the arterial duct in preterm infantsArchives of Disease in Childhood: Fetal & Neonatal, 2007
- Prenatal administration of betamethasone for prevention of patent ductus arteriosusThe Journal of Pediatrics, 1981
- Increased risk of bronchopulmonary dysplasia in infants with patent ductus arteriosusThe Journal of Pediatrics, 1979
- Randomized trial of early closure of symptomatic patent ductus arteriosus in small preterm infantsThe Journal of Pediatrics, 1978