Document Detail


Patent ductus arteriosus: are current neonatal treatment options better or worse than no treatment at all?
MedLine Citation:
PMID:  22414883     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Although a moderate-sized patent ductus arteriosus (PDA) needs to be closed by the time a child is 1-2 years old, there is great uncertainty about whether it needs to be closed during the neonatal period. Although 95% of neonatologists believe that a moderate-sized PDA should be closed if it persists in infants (born before 28 weeks) who still require mechanical ventilation, the number of neonatologists who treat a PDA when it occurs in infants who do not require mechanical ventilation varies widely. Both the high likelihood of spontaneous ductus closure and the absence of randomized controlled trials, specifically addressing the risks and benefits of neonatal ductus closure, add to the current uncertainty. New information suggests that early pharmacologic treatment has several important short-term benefits for the preterm newborn. By contrast, ductus ligation, while eliminating the detrimental effects of a PDA on lung development, may create its own set of morbidities that counteract many of the benefits derived from ductus closure.
Authors:
Ronald I Clyman; James Couto; Gail M Murphy
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review    
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:  2012-09-12     Revised Date:  2013-06-26    
Medline Journal Info:
Nlm Unique ID:  7801132     Medline TA:  Semin Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  123-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Affiliation:
Department of Pediatrics, Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA 94143, USA. clymanr@peds.ucsf.edu
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MeSH Terms
Descriptor/Qualifier:
Cardiovascular Agents / therapeutic use*
Ductus Arteriosus, Patent / drug therapy*,  physiopathology,  surgery,  therapy
Female
Humans
Indomethacin / therapeutic use*
Infant, Newborn
Infant, Premature, Diseases / drug therapy*,  physiopathology,  surgery
Ligation
Male
Pregnancy
Respiration, Artificial
Unnecessary Procedures
Grant Support
ID/Acronym/Agency:
HL109199/HL/NHLBI NIH HHS; HL46691/HL/NHLBI NIH HHS; R01 HL046691-16/HL/NHLBI NIH HHS; R01 HL109199/HL/NHLBI NIH HHS; R01 HL109199-01/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Cardiovascular Agents; 53-86-1/Indomethacin
Comments/Corrections

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