Document Detail


Patent ductus arteriosus in premature neonates.
MedLine Citation:
PMID:  22564132     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Persistent patency of the ductus arteriosus is a major cause of morbidity and mortality in premature infants. In infants born prior to 28 weeks of gestation, a haemodynamically significant patent ductus arteriosus (PDA) can cause cardiovascular instability, exacerbate respiratory distress syndrome, prolong the need for assisted ventilation and increase the risk of bronchopulmonary dysplasia, intraventricular haemorrhage, renal dysfunction, cerebral palsy and mortality. We review the pathophysiology, clinical features and assessment of haemodynamic significance, and provide a rigorous appraisal of the quality of evidence to support current medical and surgical management of PDA of prematurity. Cyclo-oxygenase inhibitors such as indomethacin and ibuprofen remain the mainstay of medical therapy for PDA, and can be used both for prophylaxis as well as for rescue therapy to achieve PDA closure. Surgical ligation is also effective and is used in infants who do not respond to medical management. Although both medical and surgical treatment have proven efficacy in closing the ductus, both modalities are associated with significant adverse effects. Because the ductus does undergo spontaneous closure in some premature infants, improved and early identification of infants most likely to develop a symptomatic PDA could help in directing treatment to the at-risk infants and allow others to receive expectant management.
Authors:
Olachi J Mezu-Ndubuisi; Ghanshyam Agarwal; Aarti Raghavan; Jennifer T Pham; Kirsten H Ohler; Akhil Maheshwari
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Drugs     Volume:  72     ISSN:  0012-6667     ISO Abbreviation:  Drugs     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-05-08     Completed Date:  2012-07-26     Revised Date:  2012-12-18    
Medline Journal Info:
Nlm Unique ID:  7600076     Medline TA:  Drugs     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  907-16     Citation Subset:  IM    
Affiliation:
Division of Neonatology, Department of Pediatrics, University of Illinois at Chicago, Chicago, IL 60612, USA.
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MeSH Terms
Descriptor/Qualifier:
Cyclooxygenase Inhibitors / therapeutic use
Ductus Arteriosus, Patent / complications*,  diagnosis,  therapy
Humans
Ibuprofen / therapeutic use
Indomethacin / therapeutic use
Infant, Newborn
Infant, Premature*
Ligation / methods
Risk Factors
Grant Support
ID/Acronym/Agency:
HD59142/HD/NICHD NIH HHS; R01 HD059142/HD/NICHD NIH HHS
Chemical
Reg. No./Substance:
0/Cyclooxygenase Inhibitors; 15687-27-1/Ibuprofen; 53-86-1/Indomethacin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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