Recent Advance in Management of Patent Ductus Arteriosus in Extremely Low Birth Weight Infants.
10.7599/hmr.2009.29.4.315
- Author:
Byung Min CHOI
1
Author Information
1. Department of Pediatrics, College of Medicine Korea University, Seoul, Korea. cbmin@korea.ac.kr
- Publication Type:Review
- Keywords:
Patent ductus arteriosus;
Indomethacin;
Ibuprofen;
Extremely low birth weight infant
- MeSH:
Cyclooxygenase Inhibitors;
Ductus Arteriosus, Patent;
Hand;
Humans;
Ibuprofen;
Indomethacin;
Infant;
Infant, Extremely Low Birth Weight;
Infant, Low Birth Weight;
Infant, Newborn;
Infant, Premature;
Ligation;
Risk Assessment;
Ventilation
- From:Hanyang Medical Reviews
2009;29(4):315-326
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Management of patent ductus arteriosus (PDA) in preterm infants has always been a challenge to the neonatologist and continues to be a controversial topic. There is no evidence that medical treatment with cyclooxygenase inhibitors for the prevention and treatment of PDA decreases mortality or serious morbidity, despite success in closure of the PDA. In practice, however, treatment decisions should be made for individual preterm infants in the absence of knowledge about benefits and risks of medical treatment should be made on the individual basis. This article attempts to review the current available, often conflicting data and to present the clinical guidelines for management of PDA in preterm infants, especially for extremely low birth weight (ELBW) infants. Prophylactic or early pre-symptomatic treatment may unnecessarily expose these infants, in whom the ductus might close spontaneously, to pharmacologic agents and their adverse effects. On the other hand, with advancing postnatal age, delayed treatment could potentially decrease successful medical closure thereby increasing the rate of surgical ligation and the complications associated with surgery. Therefore early symptomatic treatment in ELBW infants is preferred as the primary pharmacologic treatment for PDA. Conservative treatment with adjustment of ventilation and fluid restriction is beneficial as an alternative management to prophylactic pharmacologic treatment.
