Management of Patent Ductus Arteriosus in UK neonatal units
Research type
Research Study
Full title
Management of Patent Ductus Arteriosus in babies admitted to UK neonatal units: a population-based study using the National Neonatal Research Database
IRAS ID
284040
Contact name
Cheryl Battersby
Contact email
Sponsor organisation
Imperial College London
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Research Summary
The ductus arteriosus is a short blood vessel connecting the two main arteries in fetal life and usually closes in the first few days after birth. However, in over half of preterm babies, there is often delayed closure, resulting in a patent (open) ductus arteriosus (PDA). This leads to extra blood flowing to the lung and less blood flowing to other organs, which can cause problems and lead to extra load on the heart. Such PDAs are termed ‘haemodynamically significant’. Serious adverse outcomes such as death, and problems with the lungs or gut have been associated with significant PDAs, although a causal link has not been demonstrated. Management options include a 'watch and wait' approach, medical therapy with drugs (ibuprofen, indomethacin, paracetamol), and surgical management. Both medical and surgical options have potential side effects. However, despite numerous observational and randomised controlled studies, there is no consensus on the management of PDA. It is unclear whether intervention is beneficial as spontaneous closure is common in the first seven days of life, and there is little evidence that PDA closure changes clinical outcomes in preterm infants. Importantly, even when closure of PDA is desired, the optimal timing, choice of medical therapy, and indication for surgery are debated. Wide variation in PDA management is anecdotally reported in the United Kingdom, but has not been systematically described.
This project will use the National Neonatal Research Database (NNRD) which holds detailed population-level data since 2007 for all babies admitted for neonatal care in England, Wales. The NNRD holds data of over 1 million babies, and over 10 million daily care days.
The aim is to describe the management of patent ductus arteriosus in preterm babies admitted to neonatal units in England and Wales over a 10 year period (2010-2019).
Summary of Results
The management of Patent ductus arteriosus was described. Ibuprofen was the preferred drug choice and surgical interventions are becoming less frequent among very preterm infants in England and Wales.
REC name
London - Queen Square Research Ethics Committee
REC reference
20/LO/0825
Date of REC Opinion
2 Jun 2020
REC opinion
Favourable Opinion