Health

Revolutionary Update: New Guidelines for Treating PDA in Preemies

2025-05-15

Author: Wei Ling

Groundbreaking Insights from the American Academy of Pediatrics

In a significant clinical report featured in the latest issue of *Pediatrics*, the American Academy of Pediatrics has unveiled refreshed guidelines for evaluating and treating patent ductus arteriosus (PDA) in preterm infants. This update comes at a crucial time when understanding and managing this condition effectively is paramount.

Understanding PDA and Its Challenges for Preemies

Dr. Namasivayam Ambalavanan from the University of Alabama at Birmingham, along with his team, meticulously examined existing research to establish best practices for preterm infants facing prolonged ductal patency. Delayed closure of the PDA is notably frequent among these vulnerable newborns, particularly those born extremely premature.

The Role of Echocardiography in Diagnosis

Echocardiography emerges as a vital tool, enabling healthcare providers to confirm the presence of PDA and understand its impact on the infant's hemodynamics, or blood flow dynamics.

Treatment Options: Navigating Uncharted Waters

For cases deemed to have a hemodynamically significant PDA (hsPDA), there are treatment avenues available, including medicinal closure with ibuprofen or acetaminophen. However, recent studies cast doubt on the advantages of initiating treatment prophylactically or in the early stages (specifically under two weeks old), labeling such practices as unnecessary.

The Dilemma of Treatment Beyond Two Weeks

Despite the absence of definitive guidelines for managing infants with hsPDA beyond the two-week mark—where clinicians insist on potential medical closure—options remain limited. If medical approaches falter, some infants may be candidates for transcatheter closure or surgical ligation if the hsPDA persists.

A Shift in Surgical Practices

Interestingly, there has been a notable decline in the frequency of surgical PDA closures over recent years. Many medical centers now prefer the less invasive transcatheter method, reflecting an evolution in treatment philosophy.

Call for More Research and Parental Support

The authors emphasize a significant gap in evidence to direct management, highlighting the need for balanced treatment options. They advocate for parental support to encourage participation in clinical trials designed to enhance the understanding of effective treatments for this delicate condition.