| Patent ductus arteriosus in premature neonates. | |
MedLine Citation:
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PMID: 22564132 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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:
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Olachi J Mezu-Ndubuisi; Ghanshyam Agarwal; Aarti Raghavan; Jennifer T Pham; Kirsten H Ohler; Akhil Maheshwari |
Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: Drugs Volume: 72 ISSN: 0012-6667 ISO Abbreviation: Drugs Publication Date: 2012 May |
Date Detail:
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Created Date: 2012-05-08 Completed Date: 2012-07-26 Revised Date: 2012-12-18 |
Medline Journal Info:
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Nlm Unique ID: 7600076 Medline TA: Drugs Country: New Zealand |
Other Details:
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Languages: eng Pagination: 907-16 Citation Subset: IM |
Affiliation:
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Division of Neonatology, Department of Pediatrics, University of Illinois at Chicago, Chicago, IL 60612, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Cyclooxygenase Inhibitors
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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:
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HD59142/HD/NICHD NIH HHS; R01 HD059142/HD/NICHD NIH HHS |
| Chemical | |
Reg. No./Substance:
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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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