Background: A patent ductus arteriosus (PDA) is common among preterms, and prophylactic medical treatment has been advocated as the first-line approach. Conservative treatment may result in similar outcome, but without exposure to the harmful side effects of medication. A retrospective analysis revealed a ductal closure rate of 94% after conservative treatment with adjustment of ventilation (lowering the inspiratory time and increasing positive end expiratory pressure) and fluid restriction.
Objective: To study prospectively over one year the rate of PDA closure, and morbidity and mortality following conservative treatment.
Method: Prospective study (1 January 2005 – 31 December 2005) including 30 newborns ⩽30 weeks’ gestation, all of whom were being ventilated and required surfactant. Echocardiography was performed 48–72 h after birth. Clinically important PDA was conservatively treated as described above. The percentage of children with PDA, ductal ligation and major complications was determined.
Results: Ten neonates (33%) developed a clinical important PDA. Following conservative treatment the duct closed in all neonates (100%), and none required ductal ligation or medical treatment. The rates of major complications were no higher than those reported by the Vermont Oxford Network and in the literature.
Conclusion: The managed care plan resulted in an overall ductal closure rate of 100%. These results suggest that conservative treatment of PDA is a worthy alternative to prophylactic medical treatment.
- CLD, chronic lung disease
- IVH, intraventricular haemorrhage
- NEC, necrotising enterocolitis
- PDA, patent ductus arteriosus
- PEEP, positive end expiratory pressure
- conservative treatment
- ibuprofen prophylaxis
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Published Online First 9 January 2007
Competing interests: None.
Ethics committee approval and patient consent: Not needed (analysis of outcome of standard procedure in our unit).