Management of Patent Ductus Arteriosus: Redux

Investigators from multiple international institutions conducted a randomized controlled trial to compare the effectiveness of early routine treatment (ERT) of moderate to large patent ductus arteriosus (PDA) persisting beyond the first week of life to conservative treatment (CT) in premature infants. Study participants were recruited from 17 sites between 2014 and 2017 and met the following criteria: birth at ≥23 to <28 weeks’ gestation, age of 6–14 days, moderate to large PDA documented by means of echocardiography, and need for more than minimal respiratory support. Moderate to large PDA was defined as having an internal diameter of ≥1.5 mm, or a PDA left pulmonary artery diameter ratio of ≥0.5, and meeting other specific echocardiographic criteria. Neonates randomized to ERT were administered indomethacin, ibuprofen, or acetaminophen according to specific …