Document Detail


Patent ductus arteriosus in preterm infants.
MedLine Citation:
PMID:  21532100     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Patent ductus arteriosus (PDA) is a major morbidity in preterm infants, especially in extremely premature infants less than 28 weeks. The clinical signs and symptoms of PDA in preterm infants are non specific and insensitive for making an early diagnosis of significant ductal shunting. Functional echocardiography is emerging as a new valuable bedside tool for early diagnosis of hemodynamically significant ductus, even though there are no universally accepted criteria for grading the hemodynamic significance. Echocardiography has also been used for early targeted treatment of ductus arteriosus, though the long term benefits of such strategy are debatable. The biomarkers like BNP and N terminal pro BNP are currently under research as diagnostic marker of PDA. The primary mode of treatment for PDA is pharmacological closure using cyclo-oxygenase inhibitors with closure rate of 70-80%. Oral ibuprofen is emerging as a better alternative especially in Indian scenario where parenteral preparations of indomethacin are unavailable and side effects are comparatively lesser. Though pharmacological closure of PDA is an established treatment modality, there is still lack of evidence for long term benefits of such therapy as well as there is some evidence for the possible adverse effects like increased ROP and BPD rates, especially if treated prophylactically. Hence, it is prudent to reserve treatment of PDA to infants with clinically significant ductus on the basis of gestation, birth weight, serial echocardiography and clinical status to individualize the decision to treat.
Authors:
Arun Sasi; Ashok Deorari
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Indian pediatrics     Volume:  48     ISSN:  0974-7559     ISO Abbreviation:  Indian Pediatr     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-05-02     Completed Date:  2011-09-12     Revised Date:  2011-11-21    
Medline Journal Info:
Nlm Unique ID:  2985062R     Medline TA:  Indian Pediatr     Country:  India    
Other Details:
Languages:  eng     Pagination:  301-8     Citation Subset:  IM    
Affiliation:
Division of Neonatology, Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
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MeSH Terms
Descriptor/Qualifier:
Biological Markers / metabolism
Cyclooxygenase Inhibitors / therapeutic use
Ductus Arteriosus, Patent / diagnosis*,  metabolism,  therapy*,  ultrasonography
Echocardiography
Humans
Ibuprofen / therapeutic use
Indomethacin / therapeutic use
Infant, Newborn
Infant, Premature
Natriuretic Peptide, Brain / metabolism
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Cyclooxygenase Inhibitors; 114471-18-0/Natriuretic Peptide, Brain; 15687-27-1/Ibuprofen; 53-86-1/Indomethacin

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