TY - JOUR T1 - Conservative treatment for patent ductus arteriosus in the preterm JF - Archives of Disease in Childhood - Fetal and Neonatal Edition JO - Arch Dis Child Fetal Neonatal Ed SP - F244 LP - F247 DO - 10.1136/adc.2006.104596 VL - 92 IS - 4 AU - Sophie Vanhaesebrouck AU - Inge Zonnenberg AU - Piet Vandervoort AU - Els Bruneel AU - Marie-Rose Van Hoestenberghe AU - Claire Theyskens Y1 - 2007/07/01 UR - http://fn.bmj.com/content/92/4/F244.abstract N2 - 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. ER -