Letter
Medicine, General & Internal
John van den Anker
Summary: This article discusses the management of patent ductus arteriosus (PDA) and finds that expectant management is noninferior to early ibuprofen treatment in preventing complications and death. However, the study did not consider the fact that a significant percentage of infants in both groups also received acetaminophen, which has been found to have similar effectiveness to ibuprofen for PDA closure.
NEW ENGLAND JOURNAL OF MEDICINE
(2023)
Article
Medicine, General & Internal
Tim Hundscheid, Wes Onland, Elisabeth M. W. Kooi, Daniel C. Vijlbrief, Willem B. de Vries, Koen P. Dijkman, Anton H. van Kaam, Eduardo Villamor, Andre A. Kroon, Remco Visser, Susanne M. Mulder-de Tollenaer, Barbara De Bisschop, Peter H. Dijk, Daniela Avino, Catheline Hocq, Alexandra Zecic, Marisse Meeus, Tessa de Baat, Frank Derriks, Tine B. Henriksen, Kasper J. Kyng, Rogier Donders, Debbie H. G. M. Nuytemans, Bart Van Overmeire, Antonius L. Mulder, Willem P. de Boode
Summary: This trial showed that in the treatment of PDA in extremely preterm infants, expectant management was noninferior to early ibuprofen treatment in terms of necrotizing enterocolitis, bronchopulmonary dysplasia, or death at 36 weeks' postmenstrual age.
NEW ENGLAND JOURNAL OF MEDICINE
(2023)
Article
Pediatrics
Ayala Gover, Philip T. Levy, Avi Rotschild, Marcelo Golzman, Michal Molad, Karen Lavie-Nevo, Irena Kessel
Summary: Oral administration of paracetamol as a first-line agent is more efficacious to constrict the patent ductus arteriosus (PDA) than the intravenous route, irrespective of gestational age or course duration.
PEDIATRIC RESEARCH
(2022)
Editorial Material
Pediatrics
Ashutosh Kumar, Sourabh Dutta, Neeraj Gupta, Sumaira Khalil
Summary: In this multicentre trial, extremely preterm infants with echocardiographically confirmed PDA were randomly assigned to expectant management or early ibuprofen treatment. The primary outcome was a composite measure of necrotizing enterocolitis, bronchopulmonary dysplasia, or death at 36 weeks' postmenstrual age. The study found that expectant management was noninferior to early ibuprofen treatment in terms of reducing the occurrence of the primary outcome.
Article
Multidisciplinary Sciences
Joonsik Park, So J. Yoon, Jungho Han, In G. Song, Joohee Lim, Jeong E. Shin, Ho S. Eun, Kook Park, Min S. Park, Soon M. Lee
Summary: This study evaluated national epidemiologic data on infants treated for patent ductus arteriosus (PDA) in Korea and found an increase in the prevalence of PDA diagnosis and treatment in very low birth weight infants in recent years. Surgical treatment had a higher risk of mortality compared to conservative treatment, while surgical and/or medical treatments were associated with a higher risk of morbidity. Recent trends have shown an increased use of conservative management for PDA, leading to improved outcomes in very low birth weight infants.
SCIENTIFIC REPORTS
(2021)
Article
Pediatrics
Gabriel Altit, Sahar Saeed, Marc Beltempo, Martine Claveau, Anie Lapointe, Olga Basso
Summary: This study evaluated the impact of policy changes on death and bronchopulmonary dysplasia (BPD) in premature infants. The results showed that a strict nonintervention approach had little impact on infants born at 26 weeks, but led to a significant increase in death/BPD among infants born before 26 weeks.
JOURNAL OF PEDIATRICS
(2021)
Article
Obstetrics & Gynecology
Ruben Vaidya, Alexander Knee, Yvonne Paris, Rachana Singh
Summary: The study found that infants with a gestational age greater than 26 weeks, birth weight over 750 g, PDA size less than 0.2 cm, and no prior indomethacin use were associated with successful PDA closure following acetaminophen treatment. A multivariable model identified gestational age greater than 26 weeks and PDA size less than 0.2 cm as the strongest predictors.
JOURNAL OF PERINATOLOGY
(2021)
Article
Pediatrics
Koert de Waal, Nilkant Phad, Michelle Stubbs, Yan Chen, Martin Kluckow
Summary: The study found that early treatment with NSAIDs in preterm infants with patent ductus arteriosus had a higher closure rate, but did not significantly impact clinical outcomes. The recruitment rate for a future large trial was high, with a low incidence of open-label treatment.
JOURNAL OF PEDIATRICS
(2021)
Article
Pediatrics
Ronald I. Clyman, Nancy K. Hills, Gilles Cambonie, Thierry Debillon, Isabelle Ligi, Geraldine Gascoin, Juliana Patkai, Alain Beuchee, Geraldine Favrais, Xavier Durrmeyer, Cyril Flamant, Jean Christophe Roze
Summary: The study found that moderate-to-large patent ductus arteriosus shunts were associated with increased risks of BPD and BPD/death, but only when infants required intubation for 10 days or more.
PEDIATRIC RESEARCH
(2022)
Review
Pediatrics
Mikko Hallman, Jean Marc Treluyer, Outi Aikio, Jean-Christophe Roze
Summary: The aim is to find optimal management strategies for early closure of patent ductus arteriosus without serious adverse effects. Although acetaminophen shows similar efficacy as ibuprofen or indomethacin in constricting the ductus, careful dosage control is necessary to prevent toxicity. Prophylactic treatments such as vitamin A and low-dose corticosteroid supplementation may enhance the safety and efficacy of acetaminophen.
Review
Medicine, General & Internal
Peter Evans, Deirdre O'Reilly, Jonathan N. Flyer, Roger Soll, Souvik Mitra
Summary: High-certainty evidence shows that indomethacin is effective in closing a symptomatic PDA compared to placebo or no treatment in preterm infants. However, evidence is insufficient regarding effects of indomethacin on other clinically relevant outcomes and medication-related adverse effects.
COCHRANE DATABASE OF SYSTEMATIC REVIEWS
(2021)
Review
Pharmacology & Pharmacy
Dimitrios N. Katsaras, Georgios N. Katsaras, Vasiliki Chatziravdeli, Garyfalia N. Papavasileiou, Maria Touloupaki, Georgios Mitsiakos, Chrysoula Doxani, Ioannis Stefanidis, Efthimios Dardiotis
Summary: This study analyzed the efficacy and safety of paracetamol compared to ibuprofen and indomethacin for the treatment of patent ductus arteriosus (PDA) in preterm neonates. The results showed that paracetamol had similar PDA closure rates as ibuprofen and indomethacin, but had fewer adverse effects.
BRITISH JOURNAL OF CLINICAL PHARMACOLOGY
(2022)
Article
Medicine, General & Internal
Souvik Mitra, Amish Jain, Joseph Y. Ting, Nadya Ben Fadel, Christine Drolet, Ayman Abou Mehrem, Amuchou Soraisham, Bonny Jasani, Deepak Louis, Anie Lapointe, Jon Dorling, Faiza Khurshid, Abbas Hyderi, Kumar Kumaran, Jaya Bodani, Dany Weisz, Ruben Alvaro, Mohammed Adie, Miroslav Stavel, Alyssa Morin, Soume Bhattacharya, Jaideep Kanungo, Rody Canning, Xiang Y. Ye, Tara Hatfield, Courtney E. Gardner, Prakesh Shah
Summary: This study aims to compare the effectiveness of different pharmacotherapeutic agents in treating PDA in preterm infants across 22 NICUs in Canada. The primary outcome is the failure of primary pharmacotherapy, with secondary outcomes including clinical response to treatment and adverse effects. The study has been approved by ethics boards and institutional review boards of participating centers.
Article
Medicine, General & Internal
Chae Young Kim, Sung-Hoon Chung
Summary: This study aimed to evaluate the short-term morbidities and efficacy of single-dose prophylactic intravenous ibuprofen for patent ductus arteriosus (PDA) on the first day of life in preterm infants. The results showed that the prophylactic treatment with a single dose of intravenous ibuprofen reduced the occurrence of persistent PDA and intraventricular hemorrhage (>= grade 2), and shortened the duration of invasive ventilatory support, central venous catheter use, and hospital stay.
Review
Medicine, General & Internal
Bonny Jasani, Souvik Mitra, Prakeshkumar S. Shah
Summary: This study summarized the efficacy and safety of paracetamol for the treatment of patent ductus arteriosus (PDA) in preterm and low birth weight infants. The results suggested that paracetamol may have similar effectiveness as ibuprofen or indomethacin, and prophylactic paracetamol may be more effective than placebo. Early paracetamol treatment may also be more effective than placebo. Further studies are needed to establish the efficacy and safety of paracetamol in extremely low birth weight and extremely low gestational age neonates.
COCHRANE DATABASE OF SYSTEMATIC REVIEWS
(2022)