Treatment of persistent patent ductus arteriosus in preterm infants: time to accept the null hypothesis?

@article{Benitz2010TreatmentOP,
  title={Treatment of persistent patent ductus arteriosus in preterm infants: time to accept the null hypothesis?},
  author={William E. Benitz},
  journal={Journal of Perinatology},
  year={2010},
  volume={30},
  pages={241-252}
}
  • W. Benitz
  • Published 25 February 2010
  • Medicine
  • Journal of Perinatology
Medical and surgical interventions are widely used to close a persistently patent ductus arteriosus in preterm infants. Objective evidence to support these practices is lacking, causing some to question their usage. Emerging evidence suggests that treatments that close the patent ductus may be detrimental. This review examines the history of and evidence underlying these treatments. Neither individual trials, pooled data from groups of randomized-controlled trials, nor critical examination of… 
Patent ductus arteriosus: to treat or not to treat?
  • W. Benitz
  • Medicine
    Archives of Disease in Childhood: Fetal and Neonatal Edition
  • 2011
TLDR
Early, routine treatment to close a persistently patent ductus arteriosus in preterm infants does not improve outcomes and should therefore be abandoned and ductal patency should be considered a sign of rather than a direct cause of the several morbidities with which it is clearly associated.
PDA: To treat or not to treat
TLDR
Identification of extremely preterm infants at greatest risk of potential harm from a persistently patent ductus arteriosus, who may benefit most from treatment are urgently needed.
Does crossover treatment of control subjects invalidate results of randomized trials of patent ductus arteriosus treatment?
TLDR
This perspective examines the PDA treatment trials to date, with specific focus on rates of and ages of subjects at open rescue treatment, and demonstrates that ductal closure is significantly increased with treatment but does not translate to a significant decrease in major morbidities or mortality in premature infants.
Patent Ductus Arteriosus in Preterm Infants: Do We Have the Right Answers?
TLDR
Waiting for new evidence, it seems wise to employ available clinical and echocardiographic parameters of a hemodynamically significant (HS) PDA to select patients who are candidates for medical treatment.
Preterm patent ductus arteriosus: Should we treat it?
  • N. Evans
  • Medicine
    Journal of paediatrics and child health
  • 2012
TLDR
Targeting treatment on the basis of the early post‐natal constrictive response of the duct is currently being tested as a possible strategy.
Patent ductus arteriosus in preterm infants: is early transcatheter closure a paradigm shift?
TLDR
Whether TCPC represents a paradigm shift in PDA management that will result in improved short- and long-term outcomes, less bronchopulmonary dysplasia, improved neurodevelopment, or better long term renal function remains to be seen.
Patent ductus arteriosus: are current neonatal treatment options better or worse than no treatment at all?
TLDR
New information suggests that early pharmacologic treatment has several important short-term benefits for the preterm newborn, and ductus ligation, while eliminating the detrimental effects of a PDA on lung development, may create its own set of morbidities that counteract many of the benefits derived from ductus closure.
Patent Ductus Arteriosus in the Preterm Infant: Diagnostic and Treatment Options
TLDR
This integrative literature review focuses on diagnostic and treatment recommendations derived from the highest levels of evidence surrounding diagnosis, treatment methods, and outcomes of hemodynamically significant patent ductus arteriosus.
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TLDR
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TLDR
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TLDR
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