Open Access
ARTICLE
Pharmacotherapy for patent ductus arteriosus closure
John M. Ferguson
Department of Pediatrics, University of
Tennessee Health Science Center, Memphis,
Tennessee
* Corresponding Author: John M. Ferguson MD, Department of Pediatrics, University of Tennessee Health Science Center, 853 Jefferson‐ Suite 102, Memphis, TN 38103. Email:
Congenital Heart Disease 2019, 14(1), 52-56. https://doi.org/10.1111/chd.12715
Abstract
Even though up to 60% of premature infants less than 28 weeks gestation develop
persistent patent ductus arteriosus (PDA), there remains controversy regarding if,
when, and how to close the PDA. Failure to close the PDA has been associated with
significant morbidity but no cause‐and‐effect has been proven for short‐term or
long‐term outcomes in modern times. Surgical closure has the advantage of eliminating the PDA, but short‐term complications and long‐term adverse outcomes are worrisome. Intravenous indomethacin has been the “gold standard” for pharmacologic
treatment over the past 40 years with high closure rates and decreased incidence of
severe intraventricular hemorrhage (IVH) and pulmonary hemorrhage with early
treatment but without improvement in long‐term outcomes and with risk of renal
toxicity. Intravenous ibuprofen has less vasoconstrictive toxicity than indomethacin
with comparable closure rates but without improvement in IVH and with hyperbilirubinemia risks. Earlier this decade, acetaminophen (paracetamol) was discovered to
effectively close the PDA with good short‐term safety profile. Although promising,
acetaminophen treatment requires further studies regarding long‐term safety as well
as ideal dosing and route of administration.
Keywords
Cite This Article
APA Style
Ferguson, J.M. (2019). Pharmacotherapy for patent ductus arteriosus closure. Congenital Heart Disease, 14(1), 52-56. https://doi.org/10.1111/chd.12715
Vancouver Style
Ferguson JM. Pharmacotherapy for patent ductus arteriosus closure. Congeni Heart Dis. 2019;14(1):52-56 https://doi.org/10.1111/chd.12715
IEEE Style
J.M. Ferguson, "Pharmacotherapy for patent ductus arteriosus closure," Congeni. Heart Dis., vol. 14, no. 1, pp. 52-56. 2019. https://doi.org/10.1111/chd.12715