Document Detail


Managing the patent ductus arteriosus in the premature neonate: a new look at what we thought we knew.
MedLine Citation:
PMID:  22414884     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Over recent years, the clinical approach to patency of the ductus arteriosus in the premature neonate has been the subject of intensive reevaluation. What had once been considered inherently obvious is no longer to be taken for granted. In this review we will focus on some of the controversies surrounding various aspects of the pharmacologic treatment regimens for patent ductus arteriosus closure. The pros and cons of prophylactic vs therapeutic indomethacin, of early vs late therapy, of high- vs low-dose indomethacin, of single vs multiple courses of treatment, and of ibuprofen vs indomethacin will be considered. In addition, the possibility that patency of the ductus arteriosus is merely a physiological manifestation of extreme prematurity, and thus does not necessarily need to be therapeutically closed, has become a viable approach in some cases. As such, we will examine echocardiographic and biochemical criteria aimed at determining the clinical and hemodynamic significance of ductal shunting, and thereby of the need to treat. Finally, we speculate on potential therapeutic directions for the future, including individualized treatment regimens and multidrug treatment cocktails for those who fail initial monodrug therapy.
Authors:
Cathy Hammerman; Alona Bin-Nun; Michael Kaplan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Seminars in perinatology     Volume:  36     ISSN:  1558-075X     ISO Abbreviation:  Semin. Perinatol.     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-03-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7801132     Medline TA:  Semin Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  130-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Affiliation:
Department of Neonatology, Shaare Zedek Medical Center, Jerusalem, Israel; The Hebrew University Faculty of Medicine, Jerusalem, Israel.
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