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Updated: Jan 21, 2026
Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
Published on: March 6, 2019
Decrease in the frequency of treatment for patent ductus arteriosus after implementation of consensus guidelines: a
Lara Pavageau1, Luc P Brion1, Charles R Rosenfeld1
1Division of Neonatal-Perinatal Medicine, UT Southwestern Medical Center, Dallas, TX, USA.
Background:
Patent ductus arteriosus (PDA) management varies widely among neonatologists.
Local Problem:
Lack of institution-specific evidence-based guidelines for therapeutic closure of PDA.
Methods:
Quality improvement project among infants <30 weeks gestational age (GA) designed to determine whether the odds of therapy for closing the PDA, adjusted for GA, decreased after implementing evidence-based guidelines.
Intervention:
Implementation of guidelines with conservative approach to PDA management.
Results:
The frequency of PDA treatment decreased from 446/1125 (40%) in Epoch 1 to 96/482 (20%) in Epoch 2. PDA treatment was more frequent in neonates 23-26 weeks GA than those of 27-29 weeks GA (43% vs. 28%, respectively). Among 542 infants receiving indomethacin for PDA, 25% had subsequent ligation; the odds of ligation after indomethacin were lower in neonates 27-29 weeks GA and decreased during Epoch 2.
Conclusions:
The frequency of medical and surgical treatment for therapeutic closure of PDA decreased after implementing evidence-based treatment guidelines.
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