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Review
Ductus arteriosus and the preterm brain
  1. Valerie Y. Chock1,
  2. Shazia Bhombal1,
  3. Gabriel F.T. Variane2,
  4. Krisa P. Van Meurs1,
  5. William E. Benitz1
  1. 1 Pediatrics, Division of Neonatology, Stanford University School of Medicine, Stanford, California, USA
  2. 2 Pediatrics, Division of Neonatology, Irmandade da Santa Casa de Misericordia de Sao Paulo, Sao Paulo, Brazil
  1. Correspondence to Dr Valerie Y. Chock, Pediatrics, Division of Neonatology, Stanford University School of Medicine, Stanford, CA 94304, USA; vchock{at}stanford.edu

Abstract

As the approach to the patent ductus arteriosus (PDA) in the preterm infant remains controversial, the potential consequences of a significant ductal shunt on the brain should be evaluated. In this population at high risk of adverse outcomes, including intraventricular haemorrhage and white matter injury, as well as longer-term neurodevelopmental impairment, it is challenging to attribute sequelae to the PDA. Moreover, individual patient characteristics including gestational age and timing of PDA intervention factor into risks of brain injury. Haemodynamic assessment of the ductus combined with bedside neuromonitoring techniques improve our understanding of the role of the PDA in neurological injury. Effects of various PDA management strategies on the brain can similarly be investigated. This review incorporates current understanding of how the PDA impacts the developing brain of preterm infants and examines modalities to measure these effects.

  • Neonatology
  • Cardiology
  • Neurology
  • Infant Welfare
  • Technology

https://doi.org/10.1136/archdischild-2022-324111

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    Footnotes

    • Twitter @VChockMD

    • Contributors VC conceived of review concept, drafted the original manuscript, critically revised the manuscript, approved the final version, agrees to be accountable for all aspects of the work and is responsible for overall content as guarantor. SB helped draft the original manuscript, provided data for figures, critically revised the manuscript, approved the final version and agrees to be accountable for all aspects of the work. GV helped draft the original manuscript, provided data for figures, critically revised the manuscript, approved the final version and agrees to be accountable for all aspects of the work. KVM contributed to designing the work, critically revised the manuscript, approved the final version and agrees to be accountable for all aspects of the work. WEB contributed to designing the work, provided data for figures, critically revised the manuscript, approved the final version and agrees to be accountable for all aspects of the work.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.