Patent Ductus Arteriosus-Time for a Definitive Trial

Clin Perinatol. 2020 Sep;47(3):617-639. doi: 10.1016/j.clp.2020.05.007. Epub 2020 May 15.

Abstract

More than 70 randomized controlled trials have been conducted on the management of patent ductus arteriosus (PDA) in preterm infants. Yet, clinicians are unsure if treating a PDA improves clinically important outcomes. Earlier clinical trials have primarily explored which pharmacotherapeutic agent effectively closes the PDA. Because many of these trials included older infants, had widely varying PDA definitions, and provided open-label treatment, it is difficult to draw inferences on clinical outcomes based on the results of these trials. These flaws in trial design might have contributed to the growing notion that "no treatment" is a feasible option irrespective of the clinical characteristics of the infant and the PDA shunt volume.

Keywords: Patent ductus arteriosus; Preterm infant; Randomized controlled trial.

Publication types

  • Review

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Bronchopulmonary Dysplasia / epidemiology
  • Conservative Treatment
  • Ductus Arteriosus, Patent / physiopathology
  • Ductus Arteriosus, Patent / therapy*
  • Enterocolitis, Necrotizing / epidemiology
  • Gestational Age
  • Hemodynamics
  • Humans
  • Infant, Extremely Premature
  • Infant, Newborn
  • Infant, Premature
  • Ligation / methods*
  • Mortality
  • Randomized Controlled Trials as Topic*
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents, Non-Steroidal