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Defining “Haemodynamic Significance” of the Patent Ductus Arteriosus: Do We Have All the Answers?

Authors
  • Smith, Aisling
  • EL-Khuffash, Afif F.
Type
Published Article
Journal
Neonatology
Publisher
S. Karger AG
Publication Date
May 25, 2020
Volume
117
Issue
2
Pages
225–232
Identifiers
DOI: 10.1159/000506988
PMID: 32450558
Source
Karger
Keywords
License
Green
External links

Abstract

Optimum management of the patent ductus arteriosus (PDA) in preterm infants remains one of the most debated topics within the field of neonatology. Despite numerous observational studies and over 60 randomized control trials, consensus on PDA management remains elusive. In order to make meaningful progress on the controversial issue of PDA management, several key factors must be thoroughly addressed; namely (1) accurate identification of infants at greatest risk of long-term morbidities from PDA exposure, (2) acceptance that the PDA is not a dichotomous entity and an individualised approach to its management is required for each neonate, (3) international consensus on what constitutes a haemodynamically significant PDA and (4) the incorporation of multi-organ assessment when evaluating the impact a PDA may pose on overall neonatal physiology. This review assesses the evidence base available supporting various therapeutic strategies for PDA, the deficits in our current knowledge on the definition of haemodynamic significance and future directions to pursue in order to more successfully address this contentious subject.

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