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Abstract
A persistent patent ductus arteriosus (PDA) can have significant clinical consequences in preterm infants, depending on the degree of left-to-right shunting, its impact on cardiac performance, and associated perinatal risk factors that can mitigate or exacerbate the shunt. Although the best management strategy remains contentious, PDAs that have contraindications to, or have failed medical management have historically undergone surgical ligation. Recently smaller occluder devices and delivery systems have allowed for minimally invasive closure in the catheterization laboratory even in extremely premature infants. The present review summarizes the pathophysiologic manifestations, treatment options and management of hemodynamically significant PDA in preterm infants. Additionally, we review the available literature surrounding the respiratory support and outcomes of preterm infants following definitive PDA closure.
- patent ductus arteriosus
- prematurity
- surgical ligation
- transcatheter PDA closure
- transport
- anesthesia
- cardiorespiratory instability
- post-ligation cardiac syndrome
- high-frequency ventilation
Footnotes
- Correspondence: Craig R Wheeler DHSc RRT RRT-NPS, Department of Respiratory Care, Boston Children's Hospital, Boston, Massachusetts, United States; E-mail: craig.wheeler{at}childrens.harvard.edu
The authors have no conflicts of interest to disclose.
- Copyright © 2022 by Daedalus Enterprises
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Jump to section
- Article
- Abstract
- Introduction
- Hemodynamically Significant PDA
- Pulmonary Consequences of a Hemodynamically Significant PDA
- The Role of Mechanical Ventilation in the Modulation of PDA Flow
- Considerations Prior to Definitive Closure
- Treatment Options
- Mechanical Ventilation During PDA Closure
- Mechanical Ventilation After PDA Closure
- Post-Ligation Cardiac Syndrome
- Respiratory Outcomes Following PDA Closure
- Summary
- Footnotes
- References
- Figures & Data
- Info & Metrics
- References