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Reflections of the changes in patent ductus arteriosus management during the last 10 years
  1. Afif EL-Khuffash1,2,
  2. Dany E Weisz3,
  3. Patrick J McNamara3,4
  1. 1Department of Neonatology, Rotunda Hospital, Dublin, Ireland
  2. 2Department of Paediatrics, Royal College of Surgeons in Ireland, Dublin, Ireland
  3. 3Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
  4. 4Physiology and Experimental Medicine Program, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
  1. Correspondence to Dr Patrick J McNamara, Department of Paediatrics, the Hospital for Sick Children, 555 University Ave, Toronto, Ontario, Canada M5G 1X8; patrick.mcnamara{at}sickkids.ca

Abstract

Despite a large body of scientific evidence on the management of premature infants with a patent ductus arteriosus controversy remains and neonatologists remain challenged for knowing which patient to treat, what is the most optimal timing of treatment and which treatments have a positive impact on both short-term and long-term outcomes. In this review article we discuss the increased body of evidence over the past 10 years, much of which questions the role of treatment and suggests the need to reconsider how haemodynamic significance is adjudicated. In addition, we discuss novel approaches to assessment and diagnosis, and highlight areas for future investigation.

  • patent ductus arteriosus
  • targeted neonatal echocardiography
  • myocardial performance
  • hemodynamics

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