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Archives of Disease in Childhood - Fetal and Neonatal Edition 2007;92:F498-F502; doi:10.1136/adc.2005.092734
Copyright © 2007 BMJ Publishing Group Ltd & Royal College of Paediatrics and Child Health.

REVIEW

Patent ductus arteriosus: lack of evidence for common treatments

Carl L Bose and Matthew M Laughon

Division of Neonatal-Perinatal Medicine, University of North Carolina, Chapel Hill, North Carolina, USA

Correspondence to:
Carl L Bose, Division of Neonatal-Perinatal Medicine, CB#7596, UNC Hospital, Chapel Hill, NC 27599-7596, USA; cbose{at}med.unc.edu

ABSTRACT

Patent ductus arteriosus (PDA) is a common diagnosis among extremely premature infants, especially in those with lung disease. Treatments are often used to close the PDA. Despite nearly three decades of research, the question of whether the benefits of treatments to prevent ductal patency or promote closure outweigh the risks of these treatments remains unanswered. The authors rarely use treatments designed to close the PDA. This article reviews three considerations in support of this restrained approach: rates of spontaneous closure of the ductus arteriosus; adverse effect of persistent ductal patency; and benefits and risks of treatments for closure.

Abbreviations: BPD, bronchopulmonary dysplasia; CLD, chronic lung disease; COX, cyclo-oxygenase; IVH, intraventricular haemorrhage; NEC, necrotising enterocolitis; PDA, patent ductus arteriosus

Keywords: patent ductus arteriosus; indomethacin; ibuprofen; ductal ligation


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