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PDA: Does it matter?

Jalal M Abu-Shaweesh1, Eyad Almidani2

  • 1Department of Pediatrics, Cleveland Clinic Children's, Cleveland, OH, USA.

International Journal of Pediatrics & Adolescent Medicine
|May 7, 2020
PubMed
Summary

Management of persistent patent ductus arteriosus (PDA) in preterm infants has shifted towards conservative observation, with most cases closing spontaneously. Evidence for long-term morbidities linked to PDA remains unsubstantiated, guiding current treatment approaches.

Keywords:
BPDNSAIDPDAPrematurityPreterm infants

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Area of Science:

  • Neonatology
  • Pediatric Cardiology

Background:

  • Persistent patent ductus arteriosus (PDA) management in preterm infants presents ongoing challenges.
  • Historical approaches favored early closure, but recent trends emphasize conservative observation.

Purpose of the Study:

  • To review the current understanding of PDA pathophysiology, diagnosis, and management in preterm neonates.
  • To provide evidence-based recommendations for PDA treatment strategies.

Main Methods:

  • Literature review summarizing current knowledge on PDA.
  • Analysis of diagnostic criteria and management guidelines.
  • Discussion of evolving treatment trends, including transcatheter closure.

Main Results:

  • Conservative management leads to spontaneous PDA closure in most cases, negating the need for intervention.
  • The link between PDA and long-term neonatal morbidities like BPD, ROP, NEC, and NDI is not definitively established.
  • Transcatheter closure is emerging as an alternative to surgical ligation due to concerns about associated complications.

Conclusions:

  • A conservative, watchful approach is often appropriate for PDA in preterm infants.
  • Further research is needed to clarify the definition of hemodynamically significant PDA and optimize treatment timing.
  • Evidence-based guidelines are crucial for managing PDA and minimizing potential complications.