Patent ductus arteriosus in the preterm infant: to treat or not to treat?
Pharmacological and/or surgical closure of a hemodynamically significant patent ductus arteriosus (PDA) in the very preterm infant has been the standard of care over the past few decades. However, the rationale for closure of PDA has recently been challenged. In this article, the factors that have fueled the controversy of the approach to the management of PDA and the gap in our knowledge are reviewed in detail. In addition, the pros and cons of the different treatment strategies applied in clinical care are evaluated with a focus on discussing the available evidence in the literature.
Noori
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Department of Pediatrics, Neonatal-Perinatal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA. shahab-noori@ouhsc.edu
D001775:Blood Circulation; D019090:Case Management / Q000458:organization & administration; D016861:Cyclooxygenase Inhibitors / Q000627:therapeutic use; D004374:Ductus Arteriosus, Patent / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use*; D007230:Infant, Low Birth Weight / Q000254:growth & development; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development; D008026:Ligation / Q000009:adverse effects*; D008991:Monitoring, Physiologic / Q000379:methods; D016032:Randomized Controlled Trials as Topic; D059039:Standard of Care; D016896:Treatment Outcome; D057832:Watchful Waiting
D016861:Cyclooxygenase Inhibitors; D007052:Ibuprofen