Patent ductus arteriosus, its treatments, and the risks of pulmonary morbidity

A persistent left-to right shunt through a patent ductus arteriosus (PDA) increases the rate of hydrostatic fluid filtration into the lung ′s interstitium, impairs pulmonary mechanics, and prolongs the need for mechanical ventilation. In preclinical trials, pharmacologic PDA closure leads to improved alveolarization and minimizes the impaired postnatal alveolar development that is the pathologic hallmark of bronchopulmonary dysplasia (BPD). Although routine prophylactic treatment of a PDA on the day of birth does not appear to offer any more protection against BPD than delaying treatment for 2–3 days, recent evidence from quality improvement trials suggests that early pharmacologic treatment decreases the incidence of BPD com pared with a treatment approach that exposes infants to a moderate-to-large PDA shunt for the first 7–10 days after birth.
Source: Seminars in Perinatology - Category: Perinatology & Neonatology Authors: Source Type: research