Principles of Clinical Management of Patent Ductus Arteriosus in Extremely Preterm Neonates
| Autor: | Zhen Han Tan, Vijay Baral |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
0301 basic medicine
congenital hereditary and neonatal diseases and abnormalities medicine.medical_specialty Anterior Cerebral Artery medicine.medical_treatment education Indomethacin Ibuprofen law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Ductus arteriosus medicine Humans Cyclooxygenase Inhibitors Closure (psychology) Intensive care medicine Adverse effect Infusions Intravenous Ductus Arteriosus Patent Ligation Acetaminophen Randomized Controlled Trials as Topic Echocardiography Doppler Pulsed business.industry Extremely preterm Spontaneous closure Hemodynamics Infant Newborn Infant Low Birth Weight 030104 developmental biology medicine.anatomical_structure Infant Extremely Premature Pediatrics Perinatology and Child Health Practice Guidelines as Topic Treatment strategy business 030217 neurology & neurosurgery Watchful waiting |
| Zdroj: | Current pediatric reviews. 12(2) |
| ISSN: | 1875-6336 |
| Popis: | The clinical management of a patent ductus arteriosus (PDA) in preterm newborns is a controversial topic, and despite nearly three decades of research, varying opinions remain. This dilemma stems from uncertain causal linkage between PDA and neonatal comorbidities, as well as the lack of clear evidence showing that benefits of treatment outweigh risks. There has been a general shift in the management of PDA in preterm newborns from early and aggressive closure to a more conservative approach of watchful waiting and spontaneous closure. However, a firm recommendation cannot be made due to a lack of randomized controlled trials validating either treatment strategies. Although cyclooxygenase inhibitors, namely indomethacin and ibuprofen, are approved pharmacological treatments for PDA, there is a need to explore alternative medical therapies in view of lack of clinical response in many newborns and concerns over adverse effects. One such recent interest is the use of acetaminophen as a pharmacological agent. This present review tries to address the questions at hand, integrate the current evidence, highlight the principles of PDA management in preterm newborns, and suggest areas for possible future research. |
| Databáze: | OpenAIRE |
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