AAP Updates Guidance on Evaluation, Treatment of Patent Ductus Arteriosus in Preemies
By Elana Gotkine HealthDay Reporter
THURSDAY, May 15, 2025 -- In a clinical report published in the May issue of Pediatrics, the American Academy of Pediatrics presents updated guidance on the evaluation and treatment of patent ductus arteriosus (PDA) in preterm infants.
Namasivayam Ambalavanan, M.D., from the University of Alabama at Birmingham, and colleagues reviewed the available evidence to develop guidelines for evaluation and treatment of preterm infants with prolonged ductal patency.
The authors note that delayed closure of PDA is common in preterm infants, especially at more extreme immaturity. Echocardiography is essential for confirming PDA presence and assessing its hemodynamic significance. For a hemodynamically significant PDA (hsPDA), medical closure using ibuprofen or acetaminophen is an option. Recent data indicate the lack of benefits of prophylactic or early (age <2 weeks) medical PDA closure versus expectant management and, consequently, they are not recommended. Since the relative benefits and risks of expectant management with close monitoring, attempted pharmacologic closure, or procedural (transcatheter/surgical) closure have not been adequately defined, data are insufficient to support firm recommendations on management of infants with an hsPDA beyond 2 weeks of age. Medical closure of an hsPDA beyond 2 weeks of age is attempted by many clinicians. Infants may be considered for transcatheter closure or surgical ligation if the hsPDA persists despite medical therapy (or if medical therapy is contraindicated). Surgical closure of the PDA has become less frequent in recent years, and in many centers, transcatheter closure is more common.
"There is a lack of evidence to guide management, necessitating equipoise regarding treatment options and support for parents to permit enrollment of their infants in trials that can expand the available body of evidence," the authors write.
Disclaimer: Statistical data in medical articles provide general trends and do not pertain to individuals. Individual factors can vary greatly. Always seek personalized medical advice for individual healthcare decisions.
© 2025 HealthDay. All rights reserved.
Posted May 2025
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