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Patent ductus arteriosus: lack of evidence for common treatments
  1. Carl L Bose,
  2. Matthew M Laughon
  1. Division of Neonatal-Perinatal Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
  1. Carl L Bose, Division of Neonatal-Perinatal Medicine, CB#7596, UNC Hospital, Chapel Hill, NC 27599-7596, USA; cbose{at}med.unc.edu

Abstract

Patent ductus arteriosus (PDA) is a common diagnosis among extremely premature infants, especially in those with lung disease. Treatments are often used to close the PDA. Despite nearly three decades of research, the question of whether the benefits of treatments to prevent ductal patency or promote closure outweigh the risks of these treatments remains unanswered. The authors rarely use treatments designed to close the PDA. This article reviews three considerations in support of this restrained approach: rates of spontaneous closure of the ductus arteriosus; adverse effect of persistent ductal patency; and benefits and risks of treatments for closure.

  • patent ductus arteriosus
  • indomethacin
  • ibuprofen
  • ductal ligation

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Footnotes

  • Competing interests: None.

  • Abbreviations:
    BPD
    bronchopulmonary dysplasia
    CLD
    chronic lung disease
    COX
    cyclo-oxygenase
    IVH
    intraventricular haemorrhage
    NEC
    necrotising enterocolitis
    PDA
    patent ductus arteriosus

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