Patent ductus arteriosus in preterm infants, part 1: Understanding the pathophysiologic link between the patent ductus arteriosus and clinical complications

Yasser N. Elsayed, Debbie Fraser

    Research output: Contribution to journalJournal Articlepeer-review

    14 Citations (Scopus)

    Abstract

    The clinical guidelines for treating patent ductus arteriosus (PDA) have significantly evolved over the last decades from treating any ductal shunt to more conservative management where only the hemodynamically significant patent ductus arteriosus (HSPDA) is treated. This shift has resulted largely from a lack of evidence from randomized controlled trials supporting a relationship between treating a PDA and improving long-term neonatal outcomes. However, there are many unresolved issues. There is no consensus on the precise definition of HSPDA requiring treatment or a clear understanding of when to treat HSPDA. Moreover, the current evidence shows worsening of the long-term neurodevelopmental outcome for infants undergoing surgical PDA ligation. The presence of physiologic variability among preterm infants, and the presence of different compensatory mechanisms may make it difficult to establish a link between pathophysiology and longterm outcomes. That is, the physiologic variability cannot be simply assessed by randomly assigning infants into two arms of a study. Relying on research from animal and human studies, this article explains the link between the pathophysiology of a PDA and neonatal outcomes. 2017 Springer Publishing Company.

    Original languageEnglish
    Pages (from-to)265-272
    Number of pages8
    JournalNeonatal network : NN
    Volume36
    Issue number5
    DOIs
    Publication statusPublished - 2017

    Keywords

    • Neonatal outcomes
    • Neonatal pathophysiology
    • Patent ductus arteriosus
    • Preterm infants

    Fingerprint

    Dive into the research topics of 'Patent ductus arteriosus in preterm infants, part 1: Understanding the pathophysiologic link between the patent ductus arteriosus and clinical complications'. Together they form a unique fingerprint.

    Cite this