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Patent Ductus Arteriosus

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Medical Management

Cyclo-oxygenase inhibitors like Indomethacin or Ibuprofen are used to close the PDA during the 2nd week of life.

1) INDOMETHACIN Indomethacin is a non-steroidal anti-inflammatory medication. It inhibits the production of prostaglandin. This tightens and constricts the PDA and finally closing it.

Premature babies with patent ductus arteriosus are at an increased risk for complications like IVH, intraventriuclar hemorrhage (bleeding in the brain). Researches have shown that when administered within 24 hours of birth, Indomethacin can close a PDA and can bring down the risk of IVH.

Dosage: In premature infants, about 0.1-0.2 mg/kg of Indomethacin is given about three times a day for three days. This can be repeated upto two more times.

Side effects: Important side effects of Indomethacin are

 Kidney dysfunction (with decreased urine production).

 Decreased platelet aggregation and making the infant prone to bleeding.

 Necrotizing Enterocolitis [NEC] – is a grave complication involving the bowel.

Contraindications:

 Bleeding disorder.

 Kidney dysfunction.

 Hyperbilirubinemia.

 Sepsis.

 Severe Congestive heart failure

 Organ failure.

Researches

Studies have shown that treating asymptomatic patients with PDA significantly decreases the occurrence of symptoms and the need for oxygen supplementation. Long-term effects were not known.

The final evidence of the efficacy of Indomethacin comes from Evidence Based Medical Research. A Cochrane study concluded stating Indomethacin is highly successful in closing the PDA, but upto 35% of the ductus re-opens. Some of the PDAs may not close after completing the allocated treatment. Prolongation of treatment did not have any significant benefits. Surgery is indicated for such patients.

2) IBUPROFEN

Ibuprofen is also a non-steroidal anti-inflammatory drug that can be used to close a patent ductus arteriosus. It is from the same family of drugs as Indomethacin.

Studies have shown that by three days of starting Ibuprofen 60% of the PDAs have closed spontaneously.

Major adverse effect of Ibuprofen however is pulmonary hypertension. This pulmonary hypertension was responsive to nitric oxide therapy. Kidney dysfunction can cause a rise in Serum Creatinine level.

In some studies there were no statistical differences in the effectiveness of Ibuprofen and Indomethacin in the closure of patent ductus arteriosus. Chronic lung disease and pulmonary hypertension were seen in patients treated with ibuprofen. Incidence of oliguria was less.

A study performed in India in 2002 on a small group of infants and neonates concluded that oral Ibuprofen was safe and effective in premature babies with hemodynamically significant PDAs.

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What are some therapy options for improving a hoarse, high pitched voice as a result of Left Vocal Cord Paralysis.
speechpath Saturday, February 09, 2013
My son is 6 years had an operation of PDA he is fine,eats well though still thin but strong and active.its now 3month
victor6 Thursday, January 31, 2013
Without treatments, Disease Patent Ductus Arteriosus[PDA] may progress from left-to-right(acyanotic heart) shunt to right-to-left shunt(cyanotic heart) called Eisenmenger syndrome, which has a grave outcome. http://heart-consult.com
tjavailable Friday, January 28, 2011
Sir/Mam,
Pls clarify why did the PDA problem occurs for the child?
What are all reasons for PDA Problem?

My Baby had at three months baby, cardiologist surgery and clear that problem..But I have one doubt in future anyother problem occurs for child...pls reply me as soon as possible.....

Kavivarshini Tuesday, November 10, 2009
What the reasons for PDA Problem occurs to child?

Kavivarshini Saturday, November 07, 2009
My daughter had this PDA problem in 3months baby. then cardiologist surgery for my baby. She is well. now she is 1 1/2 years old...I know in future anyother problem occurs for my daughter.
Kavivarshini Saturday, November 07, 2009
I would like to know the same thing. My daughter has a pda and doesn't eat. Tube fed. How is the success rate with eating after her pda is fixed?
ProudMother Thursday, July 16, 2009
Regarding PDA - cardiac catheterization route - could you please let me know the risk factor and sucess rate.

Thanks

SureshViswanathan Friday, January 30, 2009
My name is Tracey, I am 44 years old, and at age 6 I had a PDA closure with no complications. I have led a healthy and happy life. I am married and have three beautiful children.
soccermom7 Sunday, March 20, 2011

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