Controversies around treatment of the open duct

Description

The patent ductus arteriosus continues to pose a considerable challenge to clinicians and scientists alike. Why does it close spontaneously in most infants but remain open in others? How best can we select those infants who are most likely to benefit from treatment, i.e. are there echocardiographic criteria that would help in defining a more selective treatment approach? Would it be better to take an aggressive approach and prescribe prophylactic treatment to all extremely immature infants ‑ and if so, what is the best way to define such a subgroup? Or should we be more restrictive in defining treatment indications and adopt a 'wait and see' policy in most, if not all, premature infants? Finally, are there data to suggest that one of the treatment approaches that are available to close the patent ductus arteriosus is superior to the other? This book deals with these questions and tries to give some answers, based on the evidence currently available. It is intended for neonatologists, pediatric cardiologists and researchers. Front Matter....Pages I-XII Ductal Closure After Birth – Morphological Aspects and New Insights....Pages 1-9 Treatment Results After Ductal Closure in Extremely Low Gestational Age Infants....Pages 11-35 Echocardiographic Assessment of the Patent Ductus Arteriosus in the Preterm Infant....Pages 37-54 Evaluation of the Open Duct Using Systolic Time Intervals and Doppler Sonography of Peripheral Arteries....Pages 55-64 Competitive Inhibition of Bilirubin-Albumin Binding by Ibuprofen....Pages 65-79 Controversies Around Treatment of the Open Duct....Pages 81-91 High-Dose Therapy with Cyclooxygenase- Inhibitors for Symptomatic Persistent Ductus Arteriosus in Preterms....Pages 93-113 Risks and Benefits of Aggressive and Conservative Approaches to the Management of the Patent Ductus Arteriosus in Premature Infants....Pages 115-130 Missing Data for an Evidence-Based Approach to the Treatment of a Patent Ductus Arteriosus A Small Selection of What We Do not Know Yet....Pages 131-141 Summary of the Discussions During the International Workshop on “Controversies Around Treatment of the Patent Ductus Arteriosus”....Pages 143-156 Back Matter....Pages 157-162