Interventions for patent ductus arteriosus (PDA) in preterm infants: an overview of Cochrane Systematic Reviews

Mitra, Souvik; Boode, Willem P. de; Weisz, Dany E.; Shah, Prakeshkumar S

doi:10.1002/14651858.cd013588

Cited by 10 publications

(30 citation statements)

References 45 publications

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“…The currently available systematic reviews on the use of ibuprofen, indomethacin, and acetaminophen indicate that there is a high certainty of closure with indomethacin, a moderate certainty with ibuprofen and low certainty with acetaminophen. 6 Moreover, there is a low certainty that there is little or no difference between the combination of acetaminophen and ibuprofen versus ibuprofen alone. 7 Very recently, Gupta et al reported in the New England Journal of Medicine a trial of selective early treatment of PDA with ibuprofen indicating no difference between ibuprofen and placebo!…”

Section: Neonatal Therapeutics: Time For a More Effective And Impactf...mentioning

confidence: 99%

“…Based on the totality of the available literature and clinical practice, the rationale of using two drugs to close a PDA in a preterm neonate needs to be fully understood. The currently available systematic reviews on the use of ibuprofen, indomethacin, and acetaminophen indicate that there is a high certainty of closure with indomethacin, a moderate certainty with ibuprofen and low certainty with acetaminophen 6 . Moreover, there is a low certainty that there is little or no difference between the combination of acetaminophen and ibuprofen versus ibuprofen alone 7 .…”

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confidence: 99%

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Neonatal Therapeutics: Time for a More Effective and Impactful Collaboration Between Neonatologists and Clinical Pharmacologists

van den Anker

2024

The Journal of Clinical Pharma

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Section: Neonatal Therapeutics: Time For a More Effective And Impactf...mentioning

confidence: 99%

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confidence: 99%

Neonatal Therapeutics: Time for a More Effective and Impactful Collaboration Between Neonatologists and Clinical Pharmacologists

van den Anker

2024

The Journal of Clinical Pharma

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“…Current practice when managing hsPDA, includes several pharmacological, non-pharmacological, and surgical interventions ( 67 ). The approach of limiting the ductal shunt, often referred to as conservative management, focuses on modulating the factors that dictate the shunt volume.…”

Section: Ductal Shunt Limitation Vs Eliminationmentioning

confidence: 99%

Should we “eliminate” PDA shunt in preterm infants? A narrative review

Surak,

Sidhu,

Ting

2024

Front. Pediatr.

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The patent ductus arteriosus frequently poses a significant morbidity in preterm infants, subjecting their immature pulmonary vascular bed to substantial volume overload. This, in turn, results in concurrent hypoperfusion to post-ductal organs, and subsequently alters cerebral blood flow. In addition, treatment has not demonstrated definitive improvements in patient outcomes. Currently, the optimal approach remains a subject of considerable debate with ongoing research controversy regarding the best approach. This article provides a comprehensive review of existing literature.

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“…7 Infants present with episodes of apnoea, signs of heart failure such as tachypnoea, dyspnoea with feeding, tachycardia, bounding pulse, and wide pulse pressure. 8 The infant progressively develops chronic lung disease and congestive heart failure requiring ventilator. 9…”

Section: Presentation Of Patent Ductus Arteriosusmentioning

confidence: 99%

Interventions on patent ductus arteriosus and its impact on congenital heart disease

et al. 2020

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The ductus arteriosus (DA) connects the pulmonary artery to the aorta to bypass the pulmonary circulation in utero. It normally closes within 24–72 hours after birth due to increased pulmonary resistance from an increase in oxygen partial pressure with the baby’s first breath. Medical treatment can help close the DA in certain situations where closure is delayed. However, in duct-dependent cardiac defects, the presence of the DA is crucial for survival and as such medical and surgical techniques have evolved to prevent closure. This review aims to outline the two main management options for keeping a ductus arteriosus patent. This includes stenting the PDA and shunting via a modified Blalock–Taussig shunt. Whilst both techniques exist, multicentre trials have found equal mortality end points but significantly reduced morbidity with stenting than shunting. This is also reflected by shorter recovery times, reduced requirement for extracorporeal membrane oxygenation (ECMO), and improved quality of life, although stent longevity remains a limiting factor.

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Interventions for patent ductus arteriosus (PDA) in preterm infants: an overview of Cochrane Systematic Reviews

Cited by 10 publications

References 45 publications

Neonatal Therapeutics: Time for a More Effective and Impactful Collaboration Between Neonatologists and Clinical Pharmacologists

Neonatal Therapeutics: Time for a More Effective and Impactful Collaboration Between Neonatologists and Clinical Pharmacologists

Should we “eliminate” PDA shunt in preterm infants? A narrative review

Interventions on patent ductus arteriosus and its impact on congenital heart disease

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