Therapeutic Strategies for PDA in Prematurity (How to treat PDA? When to treat PDA?)

ABSTRACT

Patent ductus arteriosus (PDA) occurs commonly in premature infants, especially extremely low birth weight infants (ELBWs) and in those with respiratory distress syndrome. About 80 percent of ELBWs have a murmur in earlier days after birth progress to large, persistent ductal shunts. Also, the ductus can reopen after closure that occurs either spontaneously or after indomethacin treatment among tiny and immature babies, more often ELBWs. Complications of prematurity that occur more commonly among infants with PDA than infants without PDA include pulmonary edema, BPD, NEC, congestive heart failure, and IVH. However there has been controversy as to whether or when the ductus arteriosus should be closed by either pharmacologic or surgical methods. Now there is still no definite standard guide-line to close PDA among prematurity especially ELBWs. Clinical decisions of the treatment of the ductus should be individualized and based on the gestation of the baby, respiratory condition and the facility of each neonatal intensive care unit.