Closing the Gap: Investigation of Various Approaches in the Management of Patent Ductus Arteriosus

In preterm newborns with extremely low birth weights, patent ductus arteriosus (PDA), which is defined as a remnant connection between the aorta and pulmonary artery after 72 hours of birth, is frequently linked to substantial morbidity and mortality. If left untreated, a hemodynamically significant...

Full description

Saved in:
Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2023-09, Vol.15 (9), p.e45009-e45009
Main Authors: Ghouse, Farhana, Idrobo Zapata, Claudia, Kasam Shiva, Pavan K, Aguilar, Anne, Siripragada, Rithika, Nair, Nandini, Vera, Emiliano, Suresh, Amrita
Format: Article
Language:English
Subjects:
Analgesics
Birth weight
Cardiac/Thoracic/Vascular Surgery
Cardiology
Clinical outcomes
Congenital diseases
Coronary vessels
Diuretics
Drug dosages
Fasting
Investigations
Lung diseases
Morbidity
Mortality
Newborn babies
Nonsteroidal anti-inflammatory drugs
Oxygen saturation
Pediatrics
Premature babies
Premature birth
Pulmonary arteries
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:In preterm newborns with extremely low birth weights, patent ductus arteriosus (PDA), which is defined as a remnant connection between the aorta and pulmonary artery after 72 hours of birth, is frequently linked to substantial morbidity and mortality. If left untreated, a hemodynamically significant PDA (hsPDA) increases the risk for bronchopulmonary dysplasia, necrotizing enterocolitis, and intraventricular hemorrhage among other morbidities, and can even lead to death. While instances of patent ductus arteriosus (PDA) resolving on their own are frequent, the primary approach for managing PDA closure in premature infants involves pharmacological interventions, commonly utilizing indomethacin, ibuprofen, or paracetamol. However, with these pharmacological treatment options, there is an increased risk of renal toxicity, gastrointestinal bleeding, and reopening of PDA among other complications. If pharmacological interventions are not successful or contraindicated, PDA can be closed via transcatheter closure or surgical ligation. As with any medically invasive procedure, it is not without risks and can lead to long-term complications. This review explores the different management options and the benefits and outcomes of conservative management vs. active management in order to get one step closer to standardizing the treatment for PDA. With so much controversy surrounding the best management option, there is a lack of evidence to support one treatment method superior to the other in reducing overall mortality, and this needs to be explored further.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.45009