- Title
- Patent Ductus Arteriosus in Premature Infants: Clinical Trials and Equipoise
- Creator
- Liguori, Macrina B.; Ali, Sanoj K. M.; Gupta, Samir; Laughon, Matthew; Bussman, Neidin; Colaizy, Tarah; Hundscheid, Tim; Phad, Nikant; Clyman, Ronald; de Boode, Willem-Pieter; de Waal, Koert; El-Khuffash, Afif
- Relation
- Journal of Pediatrics Vol. 261, Issue October 2023, no. 113532
- Publisher Link
- http://dx.doi.org/10.1016/j.jpeds.2023.113532
- Publisher
- Elsevier
- Resource Type
- journal article
- Date
- 2023
- Description
- Persistent patency of the ductus arteriosus is common in premature infants, yet patent ductus arteriosus (PDA) management varies widely. In observational studies, PDA is associated with prolonged assisted ventilation, bronchopulmonary dysplasia (BPD), pulmonary hemorrhage, necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH), periventricular leukomalacia, cerebral palsy, renal impairment, and mortality. 1-7 These associations led many clinicians to treat a PDA in all preterm infants. However randomized controlled trials (RCTs) of PDA treatment have failed to demonstrate significant reductions in clinically important outcomes. As an example, prophylactic indomethacin trials (for reducing IVH) demonstrate that indomethacin reduces incidence of symptomatic PDA, need for ligation, and IVH, but has no effect on BPD, NEC, long-term neurodevelopmental impairment (NDI) or death. 1,8 Thus, it is unclear if PDA is part of the causal pathway for development of these morbidities.
- Subject
- neonatology; research ethics; bias; study design; symposium summary; hemodynamics
- Identifier
- http://hdl.handle.net/1959.13/1483954
- Identifier
- uon:51236
- Identifier
- ISSN:0022-3476
- Language
- eng
- Reviewed
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