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Definitive Closure of the Patent Ductus Arteriosus in Preterm Infants and Subsequent Short-Term Respiratory Outcomes

Craig R Wheeler1, Elizabeth R Vogel2, Michael A Cusano3

  • 1Department of Respiratory Care, Boston Children's Hospital, Boston, Massachusetts. craig.wheeler@childrens.harvard.edu.

Respiratory Care
|April 27, 2022
PubMed

Insights

Persistent patent ductus arteriosus (PDA) in preterm infants poses risks. This review covers PDA pathophysiology, treatment options including minimally invasive closure, and respiratory support outcomes post-intervention.

Area of Science:

  • Neonatal Medicine
  • Pediatric Cardiology

Background:

  • Persistent patent ductus arteriosus (PDA) is a common complication in preterm infants.
  • Hemodynamically significant PDA can lead to severe clinical consequences, impacting cardiac performance and requiring careful management.
  • Management strategies for PDA, including medical and surgical options, remain a subject of ongoing debate.

Purpose of the Study:

  • To review the pathophysiology of hemodynamically significant PDA in preterm infants.
  • To summarize current and emerging treatment options for PDA, including minimally invasive approaches.
  • To examine respiratory support and outcomes following PDA closure in this vulnerable population.

Main Methods:

  • Comprehensive literature review of studies on PDA in preterm infants.
  • Analysis of pathophysiologic mechanisms, clinical manifestations, and management strategies.
  • Evaluation of data on respiratory support and outcomes after PDA intervention.

Main Results:

  • PDA management is complex, influenced by shunt severity and perinatal factors.
  • Minimally invasive device closure is increasingly feasible, even in extremely premature infants.
  • Respiratory support and outcomes post-closure vary and warrant further investigation.

Conclusions:

  • Effective management of hemodynamically significant PDA in preterm infants is crucial.
  • Minimally invasive closure represents a significant advancement in PDA treatment.
  • Understanding respiratory support needs and long-term outcomes post-closure is essential for optimizing infant care.

Keywords:
anesthesiacardiorespiratory instabilityhigh-frequency ventilationpatent ductus arteriosuspost-ligation cardiac syndromeprematuritysurgical ligationtranscatheter PDA closuretransport

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