Related Experiment Video

Updated: Apr 17, 2026

Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
09:31

Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography

Published on: January 27, 2023

1.9K

What is new for patent ductus arteriosus management in premature infants in 2015?

Krystle M Perez1, Matthew M Laughon

  • 1Department of Pediatrics, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.

Current Opinion in Pediatrics
|February 18, 2015
PubMed

Insights

Diagnosing and treating patent ductus arteriosus (PDA) in premature infants is complex. Current evidence suggests similar outcomes for aggressive versus conservative PDA management, with oral acetaminophen emerging as a potential therapy.

Area of Science:

  • Neonatal cardiology and critical care.
  • Perinatal medicine and developmental biology.

Background:

  • Patent ductus arteriosus (PDA) is a frequent complication in premature infants.
  • PDA is linked to numerous adverse health outcomes in neonates.
  • Accurate diagnosis and effective management of PDA remain significant clinical challenges.

Purpose of the Study:

  • To review and synthesize recent scientific literature concerning the diagnosis of PDA in premature infants.
  • To discuss current therapeutic strategies and their associated risks and benefits for PDA management.
  • To explore emerging treatments and the evidence base for different clinical approaches.

Main Methods:

  • Comprehensive literature search of recent studies on PDA diagnosis and management in premature infants.
  • Analysis of diagnostic criteria, focusing on the definition of 'hemodynamically significant' PDA.
  • Review of evidence for medical (e.g., oral acetaminophen) and surgical interventions, including transcatheter closure.

Main Results:

  • A definitive definition for 'hemodynamically significant' PDA is currently lacking, complicating diagnosis.
  • Therapeutic interventions for PDA closure (medical and surgical) are associated with ongoing controversy regarding risks and benefits.
  • Oral acetaminophen shows promise as an alternative medical therapy, but safety data are still being evaluated.
  • Transcatheter PDA closure may offer advantages over surgical ligation in terms of reduced risk and adverse events.
  • Both aggressive and conservative PDA management strategies demonstrate comparable clinically important outcomes, though evidence primarily stems from cohort studies.

Conclusions:

  • Clinical decisions regarding PDA closure should balance potential treatment adverse effects against the probability of spontaneous ductal closure.
  • The specific infant population that would most benefit from PDA closure interventions is not yet clearly defined.
  • Individualized clinical context is essential when determining the optimal management strategy for PDA in premature infants.
Abstract

More Related Videos

A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn11:27

A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn

Published on: April 7, 2023

7.8K
Closure of a Patent Foramen Ovale PFO: An Intervention Sequence10:52

Closure of a Patent Foramen Ovale PFO: An Intervention Sequence

Published on: December 23, 2022

7.2K

Related Concept Videos

Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
484
Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
562
Mitral Stenosis IV: Nursing Management01:27

Mitral Stenosis IV: Nursing Management

A comprehensive nursing assessment is essential for patients with valvular heart disease, which involves any dysfunction of the heart valves that could impact blood flow and overall heart function.Subjective Data Collection:Chief Complaint and Present Illness: Start with the patient's primary concerns, focusing on the onset, duration, and progression of cardiac symptoms such as dyspnea, fatigue, chest pain, and palpitations.Past Medical History: Collect detailed information on any previous...
395
Mitral Valve Prolapse III: Nursing Management01:19

Mitral Valve Prolapse III: Nursing Management

The nursing management of Mitral Valve Prolapse, or MVP, centers around patient education, symptom monitoring, and lifestyle modifications.Patient Education on MVP Diagnosis and Heredity: Nurses should provide comprehensive education about MVP, a condition where the mitral valve does not close appropriately during heartbeats. This education often includes the condition's pathophysiology, symptoms, and potential complications, like arrhythmias or mitral regurgitation. Though not fully...
545
Mitral Regurgitation III: Medical Management01:25

Mitral Regurgitation III: Medical Management

Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
617
Aortic Regurgitation IV: Nursing Management01:17

Aortic Regurgitation IV: Nursing Management

A nurse managing a patient with aortic regurgitation begins with a comprehensive assessment, including a review of the patient's medical history, family history, and lifestyle factors. During the cardiac examination, the nurse listens for heart sounds and checks for signs of valve abnormalities. The nurse also observes for symptoms such as dyspnea, orthopnea, and paroxysmal nocturnal dyspnea and assesses the patient's endurance and daily activity tolerance.Based on the findings, the nurse...
416