EBNEO commentary: Patent ductus arteriosus (PDA)-To treat early or not with ibuprofen?

Abstract

Patent ductus arteriosus (PDA) is common in extreme preterm infants, and its management is a subject of debate.2 A large PDA of more than 1.5 mm in diameter which is persistent beyond 3 days of age is associated with a higher mortality and morbidity as well as a greater risk of bronchopulmonary dysplasia.

Systematic reviews of randomised, controlled trials showed that pharmacological treatment with ibuprofen-induced PDA closure had no beneficial effects on clinical outcomes. Therefore, the pharmacological treatment of PDA in extreme preterm infants has decreased.6 However, the evidence to support this strategy is limited and contradictory.