Document Detail


Treatment of persistent patent ductus arteriosus in preterm infants: time to accept the null hypothesis?
MedLine Citation:
PMID:  20182439     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Medical and surgical interventions are widely used to close a persistently patent ductus arteriosus in preterm infants. Objective evidence to support these practices is lacking, causing some to question their usage. Emerging evidence suggests that treatments that close the patent ductus may be detrimental. This review examines the history of and evidence underlying these treatments. Neither individual trials, pooled data from groups of randomized-controlled trials, nor critical examination of the immediate consequences of treatment provide evidence that medical or surgical closure of the ductus is beneficial in preterm infants. These conclusions are supported by sufficient evidence. Neither continued routine use of these treatments nor additional clinical trials using similar designs seems to be justified. A definitive trial, comparing current standard management with novel strategies not primarily intended to achieve ductal closure, may be necessary to resolve doubts regarding the quality or conduct of prior studies.
Authors:
W E Benitz
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Publication Detail:
Type:  Journal Article; Review     Date:  2010-02-25
Journal Detail:
Title:  Journal of perinatology : official journal of the California Perinatal Association     Volume:  30     ISSN:  1476-5543     ISO Abbreviation:  J Perinatol     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-30     Completed Date:  2010-07-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8501884     Medline TA:  J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  241-52     Citation Subset:  IM    
Affiliation:
Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA 94304-1510, USA. benitzwe@stanford.edu
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MeSH Terms
Descriptor/Qualifier:
Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
Cardiac Surgical Procedures*
Confidence Intervals
Ductus Arteriosus, Patent / complications,  drug therapy,  surgery*
Humans
Ibuprofen / therapeutic use
Indomethacin / therapeutic use
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / drug therapy,  surgery*
Ligation
Respiratory Distress Syndrome, Newborn / complications
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents, Non-Steroidal; 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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