Therapeutic management of patent ductus arteriosus.
Management of patent ductus arteriosus (PDA) in premature neonates has always been a challenge to the neonatologist and continues to be a controversial topic. Indications for treatment are not clear. Approximately 40% of ductus arteriosus close spontaneously even in extremely-low-birth-weight neonates. Prophylactic or early pre-symptomatic treatment may unnecessarily expose these babies, in whom the ductus might close spontaneously, to pharmacologic agents and their adverse effects. On the other hand, with advancing postnatal age, delaying treatment could potentially decrease successful medical closure thereby increasing the rate of surgical ligation and the complications associated with surgery. We tried to develop some clinical guidelines for management of PDA in premature neonates based on evidence, or lack thereof, and experience.
Chiruvolu
Arpitha
A
Department of Pediatrics, Division of Neonatology, Baylor University Medical Center, Dallas, Texas 75246, USA. Arpitha.Chiruvolu@baylorhealth.edu
Jaleel
Mambarath A
MA
D004374:Ductus Arteriosus, Patent / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D017410:Practice Guidelines as Topic