Skip to main content

Patent ductus arteriosus in preterm neonates

The Indian Journal of Pediatrics volume 75, Article number: 277 (2008) Cite this article

Abstract

Failure of the ductus arteriosus to close within 48–96 hours of postnatal age results in a left to right shunt across the ductus and overloading of the pulmonary circulation. This is more likely to happen in premature neonates with respiratory distress syndrome. Deterioration in the respiratory status on day 3–4 in a ventilated neonate and unexplained metabolic acidosis may be the earliest indicators of a patent ductus arteriosus (PDA). Indomethacin is the main stay of medical management of PDA in preterm neonates. Guidelines for administration of indomethacin have been described in the protocol. Restricted fluid therapy may be beneficial in the prevention of PDA in preterm neonates. Presence of PDA in a term neonate should be investigated to rule out an underlying congenital heart disease.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

References

  1. Wechsler SB, Wernovsky G. Cardiac disorders. In Cloherty JP, Stark AR, eds. Manual on neonatal care, 6th ed. 2008; 388–435.

  2. Archer N. Cardiac diseases. In Rennie JM, Roberton NRC, eds. Textbook of neonatal care, 3rd ed. Churchill Livingstone, 1999; 687–689.

  3. Clyman RI. Patent ductus arteriosus in preterm neonates. In Taeush HW, Ballard RA, eds. Avery’s diseases of the newborn, 8th ed. WB Saunders; 2005; 816–826.

  4. Zahaka KG, Patel CR. Congenital cardiac defects. In Fanaroff AA, Martin RJ, eds. Neonatal perinatal medicine — Disorders of the fetus and infants, 6th ed. 1997; 1155–1157.

  5. Clyman RI. Treatment of premature neonates with patent ductus arteriosus: analysis of four treatment strategies. J Pediatr 1996; 128: 601–607.

    PubMed  Article  CAS  Google Scholar 

  6. Foulie WP. Prophylactic Indomethacin — systematic review and meta-analysis. Arch Dis Child 1996; 74: F81–F87.

    Article  Google Scholar 

  7. De Carolis MP, Romagnoli C, Polimeni V, Piersigilli F, Zecca E, Pappacci P et al. Prophylactic ibuprofen therapy of patent ductus arteriosus in preterm infants. Eur J Pediatr 2000; 159: 364–368.

    PubMed  Article  Google Scholar 

  8. Bose CL, Laughan MM. Patent ductus arteriosus: Lack of evidence for common treatments. Arch Dis Child Fetal Neonatal 2007; 92: F498–F502.

    Article  Google Scholar 

  9. Vanhaesebrouck S, Zonnenberg I, Vandervoot P et al. Conservative treatment for patent ductus arteriosus in the preterm. Arch Dis Child Fetal Neonatal Ed 2007; 92: F244–F247.

    PubMed  Article  Google Scholar 

  10. Brion LP, Campbell DE. Furosemide in indomethacin treated infants-systematic review and meta-analysis. Pediatr Nephrol 1999; 13: 212–218.

    PubMed  Article  CAS  Google Scholar 

  11. Fajardo CA, Whyte RK, Stele BT. Effect of dopamine on failure of indomethacin to close patent ductus arteriosus. J Pediatr 1992; 121: 771–775.

    PubMed  Article  CAS  Google Scholar 

  12. Tammela O, Ojala R, Livainen T, Lautamatti V, Pokela ML, Janas M et al. Short versus prolonged indomethacin therapy for patent ductus arteriosus in preterm infants. J Pediatr 1999; 134: 552–557.

    PubMed  Article  CAS  Google Scholar 

  13. Van Overmeire B, Smets K, Lecoutere D, Van de Broek H, Weyler J, Degroote K et al. A comparison of ibuprofen and indomethacin for closure of patent ductus arteriosus. N Engl J Med 2000; 343: 674–681.

    PubMed  Article  Google Scholar 

  14. Burke RP, Jacobs JP, Cheng W, Trento A, Fontana GP. Video-assisted thoracoscopic surgery for patent ductus arteriosus in low birth weight neonates and infants. Pediatrics 1999; 104: 227–230.

    PubMed  Article  CAS  Google Scholar 

  15. Bell EF, Acarregui MJ. Restricted versus liberal water intake for preventing morbidity and mortality in preterm infants. Cochrane Database Syst Rev 2000; 2: CD000503.

    Google Scholar 

  16. Mc Namara, Sehgal A. Towards rational management of the patent ductus arteriosus: the need for disease staging. Arch Dis Child Fetal Neonatal 2007; 92: F425–F427.

    Google Scholar 

Download references

Author information

Affiliations

  1. Division of Neonatology, Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India

    Ramesh Agarwal, Ashok K. Deorari & Vinod K. Paul

Authors
  1. Ramesh Agarwal
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ashok K. Deorari
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Vinod K. Paul
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ashok K. Deorari.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Agarwal, R., Deorari, A.K. & Paul, V.K. Patent ductus arteriosus in preterm neonates. Indian J Pediatr 75, 277 (2008). https://doi.org/10.1007/s12098-008-0059-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s12098-008-0059-9

Key words

  • Preterm
  • Patent ductus arteriosus
  • Indomethacin
  • Ibuprofen