Related Experiment Video
Updated: Nov 22, 2025
Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
Published on: January 27, 2023
Conservative Non-intervention Approach for Hemodynamically Significant Patent Ductus Arteriosus in Extremely Preterm
Se In Sung1, Yun Sil Chang1, So Yoon Ahn1
1Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Insights
Conservative management of persistent patent ductus arteriosus (PDA) in preterm infants is increasingly common, but its benefits and risks remain unclear. This review examines optimal application of the non-intervention approach, particularly for extremely preterm infants.
Area of Science:
- Neonatal Medicine
- Pediatric Cardiology
- Perinatology
Background:
- Persistent patent ductus arteriosus (PDA) in preterm infants is linked to mortality and morbidities like bronchopulmonary dysplasia and necrotizing enterocolitis.
- Traditional treatments for PDA have not consistently improved outcomes.
- A conservative, non-intervention approach is now favored, but its efficacy and safety are not well-defined.
Purpose of the Study:
- To review the current evidence on the conservative non-intervention approach for persistent PDA in preterm infants.
- To define optimal strategies for patient selection, timing, and application of non-intervention.
- To specifically address the management of PDA in extremely preterm infants.
Main Methods:
- Mini-review of existing literature.
- Analysis of outcomes associated with conservative management.
- Focus on clinical decision-making for persistent PDA.
Main Results:
- Evidence supporting causal links between PDA and morbidities is limited.
- Traditional interventions show inconsistent benefits.
- The benefits and risks of the conservative approach require further clarification.
Conclusions:
- The conservative non-intervention approach for persistent PDA is gaining traction.
- Further research is needed to clarify 'whom, when, and how' to apply this strategy, especially in extremely preterm infants.
- A nuanced approach is necessary to balance potential risks and benefits.
Abstract:
While persistent patent ductus arteriosus (PDA) in preterm infants has been known to be associated with increased mortality and morbidities including bronchopulmonary dysplasia, and necrotizing enterocolitis, there is minimal evidence supporting their causal relationships, and most traditional medical and/or surgical treatments have failed to show improvements in these outcomes. As such, the pendulum has swung toward the conservative non-intervention approach for the management of persistent PDA during the last decade; however, the benefits and risks of this approach are unclear. In this mini review, we focused on whom, when, and how to apply the conservative non-intervention approach for persistent PDA, especially in extremely preterm infants.
