Pda

Abstract

Management of persistent patent ductus arteriosus (PDA) continues to be a challenging issue. The attitude toward PDA has shifted in the opposite direction during the last 20 years, from advocating an aggressive and early closure toward a call for watchful observation. While persistent PDA may cause challenges in the medical management of preterm neonates secondary to volume overload, pulmonary edema or hemorrhage, hypotension, and impaired tissue perfusion, its contribution toward long-term neonatal morbidities including bronchopulmonary dysplasia (BPD), ROP, NEC, and NDI has not been substantiated. By advocating conservative management, it is clear now that the majority of the PDA cases show spontaneous closure and do not require treatment. However, there has not been agreement regarding what constitutes a hemodynamically significant PDA and when, if any, it should be targeted for treatment. With increasing concern regarding possible associated complications with PDA ligation, a new trend for transcatheter approach to PDA closure is expanding. In this review, we summarize current understanding of the pathophysiology, diagnosis, and management of PDA in preterm infants, and we make some recommendations regarding evidence-based approach.

Morbidity Associated with Patent Ductus Arteriosus in Preterm Newborns: A Retrospective Case-Control Study

“…This research, as well as our study, found that PDA was signi cantly correlated with ROP in the multivariate logistic regression analysis adjusted for GA and BW [34]. Taking these results into account, it is possible to hypothesize that hs-PDA, in critical ill newborns, may increase the risk of ROP due to hemodynamic instability that, in turn, may in uence development of the immature and incompletely vascularized retina [35]. We did not observe the association between hs-PDA and ROP in ELGAN and ELBW patients.…”

Morbidity associated with patent ductus arteriosus in preterm newborns: a retrospective case-control study

“…It is known that pO 2 regulates the production of predominant regulators of retinal angiogenesis, therefore O 2 therapy could be responsible for the retinal damage associated with ROP pathogenesis [35]. However, taking these results into account, it is possible to hypothesize that hs-PDA, in critical ill newborns, may contribute to increase the risk of ROP due to hemodynamic instability that, in turn, may influence development of the immature and incompletely vascularized retina [36]. We did not observe the association between hs-PDA and ROP in ELGAN and ELBW patients.…”

Morbidity associated with Patent Ductus Arteriosus in Preterm Newborns: A Retrospective Case-Control Study

“…It is known that pO 2 regulates the production of predominant regulators of retinal angiogenesis, therefore O 2 therapy could be responsible for the retinal damage associated with ROP pathogenesis [36]. However, taking these results into account, it is possible to hypothesize that hs-PDA, in critical ill newborns, may contribute to increase the risk of ROP due to hemodynamic instability that, in turn, may in uence development of the immature and incompletely vascularized retina [37]. We did not observe the association between hs-PDA and ROP in ELGAN and ELBW patients.…”