closure of the ductus arteriosus
Last edited 03/2021 and last reviewed 05/2022
There are a number of approaches:
- in a neonate in intensive care fluid restriction may be a first line of management
- indomethacin inhibits prostaglandin synthesis and may cause closure of the ductus
- Some evidence suggests that ibuprofen may be just as effective as indomethacin and less toxic particularly to the kidneys.
- surgical ligation may be undertaken following medical correction of any signs of heart failure
A systematic review concluded (1):
- High-certainty evidence shows that indomethacin is effective in closing a symptomatic PDA compared to placebo or no treatment in preterm infants. Evidence is insufficient regarding effects of indomethacin on other clinically relevant outcomes and medication-related adverse effects
Reference:
- Evans P et al.
Indomethacin for symptomatic patent ductus arteriosus in preterm infants.
Cochrane Database of Systematic Reviews 2021, Issue 1. Art. No.: CD013133.
DOI: 10.1002/14651858.CD013133.pub2