Changes in PDA treatment strategy and respiratory outcomes: Optimal timing of intervention … continuing the long conversation

Abstract

Premature newborns with respiratory failure often require mechanical ventilation. Prolonged mechanical ventilation, lower gestational age, lower birthweight, small for gestational age, resuscitation, infections, hyperoxia, genetic factors, poor nutrition and male gender predispose these patients to bronchopulmonary dysplasia (BPD). 1Patent ductus arteriosus (PDA) contributes to respiratory failure through pulmonary overcirculation. 2,3 Previous studies have shown an association between PDA and BPD but not causality. This uncertainty about the clinical impact of PDA has resulted in a variety of treatment approaches. Many centres have adopted protocols incorporating a combination of expert opinion guidelines and echocardiography to diagnose and manage a haemodynamically significant (HDS) PDA. 4,5 However, these guidelines and interpretations may not be followed due to bedside clinician's discretion and lack of equipoise. How to cite this article: Gowda SH, Patil MS. Changes in PDA treatment strategy and respiratory outcomes: Optimal timing of intervention … continuing the long conversation. Acta