What Is the Best Treatment for Symptomatic Patent Ductus Arteriosus?

Delayed closure of the patent ductus arteriosus (PDA) commonly occurs in extremely preterm infants (<29 weeks gestation), and in some infants, it can compromise pulmonary function and systemic blood flow. However, decisions regarding if, when, and how to treat a hemodynamically significant PDA remain a topic of considerable debate. Researchers conducted a meta-analysis of randomized trials published between 1980 and 2017 that compared various medical strategies (indomethacin, ibuprofen, acetaminophen) to each other, placebo, or no treatment for closure of a hemodynamically significant PDA. Bayesian network meta-analysis techniques were used to estimate the relative efficacy of 14 variations of therapy, including intravenous, oral, high-dose…