Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-28T16:43:13.851Z Has data issue: false hasContentIssue false
  • English
  • Français

Persistent Patent Ductus Arteriosus

Published online by Cambridge University Press:  10 March 2009

Ronald I. Clyman
Ronald I. Clyman
Affiliation:
Mt. Zion Hospital and Medical Center, San Francisco
Get access Rights & Permissions [Opens in a new window]

Extract

Two observations about the ductus arteriosus are established: most normally developed infants will have a patent ductus arteriosus (PDA) at the time of delivery, and most fullterm infants will have anatomic obliteration of the ductus lumen by 3–6 months of age. Studies designed to determine how a PDA contributes to an infant's morbidity or when a PDA becomes a persistently patent ductus arteriosus have been hampered by the lack of consistent diagnostic criteria for defining the condition. Ellison et al. (22) attempted to evaluate several commonly used criteria for diagnosing a large leftto-right shunt through the ductus arteriosus by noting the occurrence of each sign both before and 36–48 hours after surgical ligation. No single criterion sufficed as an indicator of PDA. Certain signs, such as continuous murmur or hyperactive left ventricular impulse, were specific for a PDA, but lacked sensitivity; conversely, M-mode echocardiography and ventilatory support criteria were very sensitive but lacked specificity.

Type
Neonatal Disorders of Circulation
Information
International Journal of Technology Assessment in Health Care , Volume 7 , Supplement S1 , January 1991 , pp. 70 - 78
Copyright
Copyright © Cambridge University Press 1991

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Achanti, B., Yeh, T. F., & Pildes, R. S.Indomethacin therapy in infants with advanced postnatal age and patent ductus arteriosus. Clinical and Investigative Medicine, 1986, 9, 250–53.Google ScholarPubMed
2.Alpan, G. M., Eyal, F., Vinograd, I., Udassin, R., Amir, G. M., Mogle, P., & Glick, B.Local ized intestinal perforations after enteral administration of indomethacin in premature in fants. Journal of Pediatrics, 1985, 106, 277–81.CrossRefGoogle Scholar
3.Alpan, G., Mauray, F., & Clyman, R. I.Effect of the ductus arteriosus on water and protein leaks in the premature lung. Clinical Research, 1988, 36, 239A.Google Scholar
4.Alpert, B. S., Lewins, M. J., Rowland, D. W., Grant, M. J. A., Olley, P. M., Soldin, S. J., Swyer, P. R., Coceani, E, & Rowe, R. D.Plasma indomethacin levels in preterm newborns with symptomatic patent ductus arteriosus: clinical and echocardiographic assessments of response. Journal of Pediatrics, 1979, 95, 578–82.Google Scholar
5.Appleton, R. S., Graham, T. P., Cotton, R. B., Moreau, G. A., & Boucek, R. J.Abnormal diastolic cardiac function following indomethacin therapy of patent ductus arteriosus. Pediatric Research, 1986, 20, 167A.Google Scholar
6.Bell, E. F., Warburton, D., Stonestreet, B., & Oh, W.Effect of fluid administration on the development of symptomatic patent ductus arteriosus and congestive heart failure in premature infants. New England Journal of Medicine, 1980, 302, 598–604.Google Scholar
7.Bhat, R., Vidyasagar, D., Fisher, E., Hastreiter, A., Ramirez, J. L., Burns, L., & Evans, M.Pharmacokinetics of oral and intravenous indomethacin in preterm infants. Developmental and Pharmalogical Therapeutics, 1980, 1, 101–10.Google Scholar
8.Bianchetti, G. M., Monin, P., Marchal, F., Dubruc, C., Boutroy, M. J., Morselli, P. L., & Vert, P.Pharmacokinetics of indomethacin in the premature infants. Developmental and Pharmacological Therapeutics, 1980, 1, 111–24.Google Scholar
9.Brash, A. R., Hickey, D. E., Graham, T. P., Stahlman, M. T., Oates, J. A., & Cotton, R. B.Pharmacokinetics of indomethacin in the neonate. New England Journal of Medicine, 1981, 305, 67–72.Google Scholar
10.Clyman, R. I.Ductus arteriosus: current theories of prenatal and postnatal regulation. Seminars in Perinatology, 1987, 11, 64–71.Google ScholarPubMed
11.Clyman, R. I., Ballard, P. L., Sniderman, S., Ballard, R. A., Roth, R., Heymann, M. A., & Granberg, J. P.Prenatal administration of betamethasone for prevention of patent ductus arteriosus. Journal of Pediatrics, 1981, 98, 123–26.Google Scholar
12.Clyman, R. I., Campbell, D., Heymann, M. A., & Mauray, F.Persistent responsiveness of the neonatal ductus arteriosus in immature lambs: a possible cause for reopening of patent ductus arteriosus after indomethacin induced closure. Circulation, 1985, 71, 141–45.Google Scholar
13.Clyman, R. I., Mauray, F., Roman, C., Heymann, M. A., Ballard, P. L., Rudolph, A. M., & Payne, B.Effects of antenatal glucocorticoid administration on the ductus arteriosus of preterm lambs. American Journal of Physiology, 1981, 241, H415–20.Google Scholar
14.Clyman, R. I., Mauray, F., Roman, C., Heymann, M. A., & Payne, B.Factors determining the loss of ductus arteriosus responsiveness to prostaglandin E. Circulation, 1983, 68, 433–36.Google Scholar
15.Clyman, R. I., Saugstad, O. D., & Mauray, F.Oxygen metabolites stimulate prostaglandin E2 production and relaxation of the ductus arteriosus. Clinical Research, 1988, 36, 228A.Google Scholar
16.Coceani, F., Hamilton, N. C., Labuc, J., & Olley, P. M.Cytochrome P 450 linked menooxygenase: Involvement in the lamb ductus arteriosus. American Journal of Physiology, 1984, 246, H640–43.Google Scholar
17.Collaborative Group on Antenatal Steroid Therapy. Prevention of respiratory distress syndrome: Effect of antenatal dexamethasone administration. Publication No. 85–2695, 44. Bethesda, MD: National Institutes of Health, 1985.Google Scholar
18.Cotton, R. B., Lindstrom, D. P., & Stahlman, M. T.Early prediction of symptomatic patent ductus arteriosus from perinatal risk factors: discriminant analysis. Acta Paediatrica Scandinavica, 1981, 70, 723–27.CrossRefGoogle ScholarPubMed
19.Cotton, R. B., Stahlman, M. T., Berder, H. W., Graham, T. P., Catterton, W. Z., & Kover, I.Randomized trial of early closure of symptomatic patent ductus arteriosus in small preterm infants. Journal of Pediatrics, 1978, 93, 647–51.CrossRefGoogle ScholarPubMed
20.Drayton, M. R., & Skidmore, R.Ductus arteriosus blood flow during first 48 hours of life. Archives of Disease in Childhood, 1987, 62, 1030–34.Google Scholar
21.Dudell, G. G., & Gersony, W. M.Patent ductus arteriosus in neonates with severe respiratory disease. Journal of Pediatrics, 1984, 104, 915–20.Google Scholar
22.Ellison, R. C., Peckham, G. J., Lang, P., Talner, N. S., Lerer, T. J., Lin, L., Dooley, K. J., & Nadas, A. S.Evaluation of the preterm infant for patent ductus arteriosus. Pediatrics, 1983, 71, 364–72.Google Scholar
23.Fay, F. S., & Jobsis, F. F.Guinea pig ductus arteriosus. III. Light absorption changes during response to O2. American Journal of Physiology, 1972, 223, 588–95.Google Scholar
24.Ferguson, M. G., Rhodes, P. G., & Joransen, J. A.Prolonged treatment of patent ductus arteriosus with indomethacin. Pediatric Research, 1985, 19, 341A.Google Scholar
25.Firth, J., & Pickering, D.Timing of indomethacin therapy in persistent ductus. Lancet, 1980, ii, 144.CrossRefGoogle Scholar
26.Friedman, Z., Whitman, V., Maisels, M. J., Berman, W. Jr., Marks, K. H., & Vessel, E. S.Indomethacin disposition and indomethacin induced platelet dysfunction in premature infants. Journal of Clinical Pharmacology, 1978, 18, 272–79.Google Scholar
27.Gentile, R., Stevenson, G. M., Dooley, T., Franklin, D., Kawabori, I., & Pearlman, A.Pulsed Doppler echocardiographic determination of time of ductal closure in normal newborn infants. Journal of Pediatrics, 1981, 98, 443–48.Google Scholar
28.Gersony, W. M., Peckham, G. J., Ellison, R. C., Miettinen, O. S., Nadas, A. S.Effect of indomethacin in premature infants with patent ductus arteriosus. Results of a national collaborative study. Journal of Pediatrics, 1983, 102, 895–906.CrossRefGoogle ScholarPubMed
29.Gittenberger-de-Groot, A. C.Persistent ductus arteriosus: most probably a primary congenital malformation. British Heart Journal, 1977, 39, 610–18.Google Scholar
30.Green, R. S., Bada, H. S., & Leffler, C. W.Controlled trial of indomethacin prevention of neonatal intraventricular/periventricular hemorrhage (IVH/PVH). Pediatric Research, 1987, 21, 362A.Google Scholar
31.Green, T. P., Thompson, T. R., Johnson, D., & Lock, J. E.Fluid administration and the development of patent ductus arteriosus. New England Journal of Medicine, 1980, 303, 337–38.Google Scholar
32.Hammerman, C., Strates, C., & Valaitis, S.The silent ductus: Its precursors and its aftermath. Pediatric Cardiology, 1986, 7, 121–127.CrossRefGoogle ScholarPubMed
33.Huhta, J. C., Cohen, M., & Gutgesell, H. P.Patency of the ductus arteriosus in normal neonates: Two dimensional echocardiography versus Doppler assessment. Journal of the American College of Cardiology, 1984, 4, 561–64.Google Scholar
34.Ivey, H. H., Kattwinkel, J., Park, T. S, & Krovetz, L. J.Failure of indomethacin to close patent ductus arteriosus in infants weighing under 1000g. British Heart Journal, 1979, 41, 304–07.Google Scholar
35.Kaapa, P., Lanning, P., & Koivisto, M.Early closure of patent ductus arteriosus with indomethacin in preterm infants with idiopathic respiratory distress syndrome. Acta Paediatrica Scandinavica, 1983, 72, 179–84.Google Scholar
36.Kennedy, J. A., & Clark, S. L.Observations on the physiological reaction of the ductus arteriosus. American Journal of Physiology, 1942, 136, 140–47.CrossRefGoogle Scholar
37.Krueger, E., Mellander, M., Bratton, D., & Cotton, R.Prevention of symptomatic patent ductus arteriosus with a single dose of indomethacin. Journal of Pediatrics, 1987, 111, 749–54.Google Scholar
38.Lilien, L. D., Srinivasan, G. M., Yeh, T. F., & Pildes, R. S.Decreased plasma glucose following indomethacin therapy in small prematures with PDA. Pediatric Research, 1983, 17, 323A.Google Scholar
39.Mahony, L., Caldwell, R. L., Cirod, D. A., Hurwitz, R. A., Jansen, R. D., Lemons, J. A., & Schreiner, R. L.Indomethacin therapy on the first day of life in infants with very low birth weights. Journal of Pediatrics, 1985, 106, 801–05.Google Scholar
40.Mahony, L., Carnero, V., Brett, C., Heymann, M. A., & Clyman, R. I.Prophylactic indomethacin therapy for patent ductus arteriosus in very low birth weight infants. New England Journal of Medicine, 1982, 306, 506–10.CrossRefGoogle ScholarPubMed
41.Mellander, M., Leheup, B., Lindstrom, D. P., Palure, C., Graham, T. P. Jr., Stahlman, M. T., & Cotton, R. B.Recurrence of symptomatic patent ductus arteriosus in extremely premature infants, treated with indomethacin. Journal of Pediatrics, 1984, 105, 138–43.Google Scholar
42.Mellander, M., Larsson, L. E., Ekström-Jodal, B., & Sabel, K. G.Prediction of symptomatic patent ductus arteriosus in preterm infants using Doppler and M-mode echocardiography. Acta Paediatrica Scandinavica, 1987, 76, 553–59.CrossRefGoogle ScholarPubMed
43.Ment, L. R., Duncan, C. C., Ehrenkranz, R. A., Kleinman, C. S., Pitt, B. R., Taylor, K. J. W., Scott, D. T, Stewart, W. B., & Gettner, P.Randomized indomethacin trial for prevention of intraventricular hemorrhage in very low birth weight infants. Journal of Pediatrics, 1985, 107, 937–43.Google Scholar
44.Merritt, T. A., Harris, J. P., Roghmann, K., Wood, B., Campella, V., Alexson, C., Manning, J., & Shapiro, D. L.Early closure of the patent ductus arteriosus in very low birth-weight infants. A controlled trial. Journal of Pediatrics, 1981, 99, 281–86.Google Scholar
45.Momma, K., Mishihara, S. & Ota, Y.Constriction of the fetal ductus arteriosus by glucocorticoid hormones. Pediatric Research, 1981, 15, 19–21.Google Scholar
46.Musewe, N. N., Smallhorn, J. F., Benson, L. N., Burrows, P. E., & Freedom, R. M.Valida-tion of Doppler derived pulmonary arterial pressure in patients with ductus arteriosus under different hemodynamic states. Circulation, 1987, 76, 1081–91.Google Scholar
47.Nestrud, R. M., Hill, D. E., Arrington, R. W., Beard, A. G., Duncan, W. T., Lau, P-Y., Norton, J. B., & Readinger, R. I.Indomethacin treatment in patent ductus arteriosus. Developmental and Pharmacological Therapeutics, 1980, 1, 125–36.Google Scholar
48.Nystrom, G. A., Setzer, E. S., Zilleruelo, G. E., Caveny, M. C., & Strauss, J.Prophylactic indomethacin: effects on renal function. Pediatric Research, 1985, 19, 178A.Google Scholar
49.Pérez Fontán, J. J., Clyman, R. I., Mauray, F., Heymann, M. A., & Roman, C.Respiratory effects of a patent ductus arteriosus in preterm newborn lambs. Journal of Applied Physiology, 1987, 63, 2315–24.Google Scholar
50.Puckett, C. G., Cox, M. A., Haskins, K. S., & Fisher, D. J.Prophylactic indomethacin for the prevention of patent ductus arteriosus. Pediatric Research, 1985, 19, 358A.Google Scholar
51.Ramsey, J. M., Murphy, D. J., Vick, G. W. III, Courtney, J. T., Garcia-Prats, J. A., & Huhta, J. C.Response of the patent ductus arteriosus to indomethacin treatment. American Journal of Diseases of Children, 1987, 141, 294–97.Google Scholar
52.Rennie, J. M., Doyle, J., & Cooke, R. W. I.Early administration of indomethacin to preterm infants. Archives of Disease in Childhood, 1986, 61, 233–38.Google Scholar
53.Rheuban, K. S., Everett, A. D., Zellers, T. M., Gallaher, K., Smith, D. J., Boyle, R. J., Kattwinkel, J., Shipe, J. R., & Gutgesell, H. P.Ductus arteriosus closure rates and indomethacin levels in premature infants. Pediatric Research, 1987, 21, 387A.Google Scholar
54.Rudd, P., Montanez, P., Hallidie-Smith, K., & Silverman, M.Indomethacin treatment for patent ductus arteriosus in very low birthweight infants: Double blind trial. Archives of Disease in Childhood, 1983, 58, 267–70.CrossRefGoogle ScholarPubMed
55.Setzer, E. S., Torres-Arraut, E., Gomez del Rio, M., Young, M. L., Pacheco, I., Ferrer, P. L., Schert, R. F., & Baucalari, E.Cardiopulmonary effects of prophylactic indomethacin in the very low birthweight infant. Pediatric Research, 1984, 18, 346A.Google Scholar
56.Setzer-Bandstra, E., Duenas, M. L., Rodriguez, I., Chao, H-S., Montalvo, B. M., Bauer, C. R., & Bancalari, E.Prophylactic indomethacin for prevention of intraventricular hemorrhage (IVH): Neurodevelopmental follow-up. Pediatric Research, 1987, 21, 391A.Google Scholar
57.Seyberth, H. W., Rasher, W., Hackenthal, R., & Wille, L.Effect of prolonged indomethacin therapy on renal function and selected vasoactive hormones in very low birth weight infants with symptomatic patent ductus arteriosus. Journal of Pediatrics, 1983, 103, 979–84.Google Scholar
58.Shimada, S., Raju, T., Bhat, R., Vidyasagar, D., Jones, W., & Maeta, H.Early PDA ligation in surfactant treated animal with hyaline membrane disease does not improve pulmonary function. Pediatric Research, 1987, 21, 466A.Google Scholar
59.Siassi, B., Blanco, C., Cabal, L. A., & Goran, A. G.Incidence and clinical features of patent ductus arteriosus in low birth weight infants: A prospective analysis of 150 consecutively born infants. Pediatrics, 1976, 57, 347–51.CrossRefGoogle ScholarPubMed
60.Smith, M., Setzer, E. S., Garg, D. C., & Goldberg, R. N.Pharmacokinetics of prophylactic indomethacin in very low birthweight premature infants. Pediatric Research, 1984, 18, 161 A.Google Scholar
61.Sola, A., Rogido, M., Lezama, C., & Urman, J. E.Effects of “prophylactic” i.v. indomethacin in VLBW infants with HMD. Pediatric Research, 1986, 20, 361A.Google Scholar
62.Stevenson, J. G., Kawabori, I., & Guntheroth, W. G.Pulsed doppler echocardiographic diagnosis of patent ductus arteriosus: Sensitivity, limitations and technical features. Catheterization and Cardiovascular Diagnosis, 1980, 6, 255–63.Google Scholar
63.Thalji, A. A., Carr, I., Yeh, T. F., Raval, D., Luken, J. A., & Pildes, R. S.Pharmacokinetics of intravenously administered indomethacin in premature infants. Journal of Pediatrics, 1980, 97, 995–1000.Google Scholar
64.Thibeault, D. W., Emmanouilides, G. C., & Dodge, M. E.Pulmonary and circulatory function in preterm lambs treated with hydrocortisone in utero. Biology of the Neonate, 1978, 34, 238–47.Google Scholar
65.Thibeault, D. W., Emmanouilides, G. C., Nelson, R. J., Lachman, R. S., Rosengart, R. M., & Oh, W.Patent ductus arteriosus complicating the respiratory distress syndrome in preterm infants. Journal of Pediatrics, 1975, 86, 120–26.Google Scholar
66.Vincer, M., Allen, A., Evans, J. R., Nwaesei, C., Stinson, D., Rees, E., & Fraser, A.Early intravenous indomethacin prolongs respiratory support in very low birthweight infants. Acta Paediatrica Scandinavica, 1987, 76, 894–97.Google Scholar
67.Waffarn, F., Siassi, B., Cabal, L., & Schmidh, P. L.Effect of antenatal glucocorticoids on clinical closure of the ductus arteriosus. American Journal of Diseases of Children, 1983, 137, 336–38.Google ScholarPubMed
68.Yaffe, S. J., Friedman, W. F., Rogers, D., Lang, P., Rangi, M., & Saccar, C.The disposition of indomethacin in premature babies. Journal of Pediatrics, 1980, 97, 1001–06.CrossRefGoogle Scholar
69.Yeh, T. F., Achanti, B., Jain, R., Patel, H., & Pildes, R. S.Indomethacin therapy in premature infants with PDA determination of therapeutic plasma levels. Pediatric Research, 1985, 19, 371A.Google Scholar
70.Yeh, T. F., Luken, J. A., Ravel, D., Thalji, A., Carr, I., & Pildes, R. S.Indomethacin treatment in small versus large premature infants with ductus arteriosus—Comparison of plasma indomethacin concentration and clinical response. British Heart Journal, 1983, 50, 27–30.Google Scholar
71.Yeh, T. F., Luken, J. A., Thalji, A., Raval, D., Carr, I., & Pildes, R. S.Intravenous indomethacin therapy in premature infants with persistent ductus arteriosus —a double blind controlled study. Journal of Pediatrics, 1981, 98, 137–45.Google Scholar