Patent Ductus Arteriosus in Extremely Preterm Infants: Update on Current Diagnostic and Treatment Options.

IF 0.6 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Treatment Options in Cardiovascular Medicine Pub Date : 2025-01-01 Epub Date: 2025-07-22 DOI:10.1007/s11936-025-01101-6

Kimberly Fernandez Trahan, Elaine L Shelton, Maria Gillam-Krakauer

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引用次数: 0

Abstract

Purpose of review: Patent ductus arteriosus (PDA) treatment strategies in the neonatal period differ widely. Variations in what constitutes hemodynamic significance (hsPDA) and scarcity of high-quality data on long-term outcomes has contributed to lack of standardization. Filling these knowledge gaps would impact clinical decision making.

Recent findings: Recent trials have not shown improvement in outcomes with early compared to expectant management. Targeted neonatal echocardiography (TnECHO) has facilitated timely intervention with encouraging outcomes. Acetaminophen use is increasing even in infants < 24 weeks. Advancements in percutaneous transcatheter occlusion, characterization of the unique expression of genes and ion channels of the ductus arteriosus, and attention to nonpharmacologic strategies are essential advances in PDA management.

Summary: With increased utilization of TnECHO, clarification of the scope of transcatheter-based closures, further understanding of the genetic and molecular factors involved in ductal tone, and the appreciation of the off-target effects that medications and fluid balance can have on the DA, providing targeted, individualized PDA treatment is achievable. However, the development of innovative therapies to promote ductal closure is a necessity.

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极早产儿动脉导管未闭：当前诊断和治疗方案的更新。

回顾目的：新生儿期动脉导管未闭（PDA）的治疗策略差异很大。血液动力学意义（hsPDA）的差异和长期结果高质量数据的缺乏导致缺乏标准化。填补这些知识空白将影响临床决策。最近的发现：最近的试验并没有显示早期治疗与预期治疗相比有改善的结果。有针对性的新生儿超声心动图（TnECHO）促进了及时干预和令人鼓舞的结果。摘要：随着TnECHO应用的增加，经导管闭合范围的明确，对导管张力的遗传和分子因素的进一步了解，以及对药物和体液平衡可能对DA产生的脱靶效应的认识，提供有针对性的个体化PDA治疗是可以实现的。然而，发展创新疗法来促进导管闭合是必要的。

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来源期刊

Current Treatment Options in Cardiovascular Medicine Medicine-Cardiology and Cardiovascular Medicine

CiteScore

2.00

自引率

0.00%

发文量

期刊介绍： This journal aims to review the most important, recently published treatment-related advances in cardiovascular medicine. By providing clear, insightful, balanced contributions by international experts, the journal intends to elucidate novel approaches to treatment in those affected by the spectrum of cardiovascular-related diseases and conditions. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as coronary artery disease, cerebrovascular disease and stroke, heart failure, pediatric and congenital heart disease, and valvular, myocardial, pericardial, and cardiopulmonary diseases. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. We also provide commentaries from well-known figures in the field, and an international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research.