Key result
Management of patent ductus arteriosus in preterm infants lacks consensus despite over 60 randomized trials, requiring individualized approaches and standardized definitions of hemodynamic significance.
Why the study?
Optimum management of PDA in preterm infants remains highly debated, and consensus remains elusive despite numerous observational studies and over 60 randomized control trials.
This review emphasizes the need for individualized management and international consensus on defining haemodynamic significance in preterm infants with patent ductus arteriosus.
Advocates individualized preterm PDA management now; leaves open international consensus definitions and multi-organ trials.
Optimum management of the patent ductus arteriosus (PDA) in preterm infants remains one of the most debated topics within the field of neonatology. Despite numerous observational studies and over 60 randomized control trials, consensus on PDA management remains elusive. In order to make meaningful progress on the controversial issue of PDA management, several key factors must be thoroughly addressed; namely (1) accurate identification of infants at greatest risk of long-term morbidities from PDA exposure, (2) acceptance that the PDA is not a dichotomous entity and an individualised approach to its management is required for each neonate, (3) international consensus on what constitutes a haemodynamically significant PDA and (4) the incorporation of multi-organ assessment when evaluating the impact a PDA may pose on overall neonatal physiology. This review assesses the evidence base available supporting various therapeutic strategies for PDA, the deficits in our current knowledge on the definition of haemodynamic significance and future directions to pursue in order to more successfully address this contentious subject.
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Smith et al. (2020) conducted a review in Patent ductus arteriosus in preterm infants. Therapeutic strategies for patent ductus arteriosus was evaluated. Management of patent ductus arteriosus in preterm infants lacks consensus despite over 60 randomized trials, requiring individualized approaches and standardized definitions of hemodynamic significance.
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