N/IICU Clinical Pathway for the Management of PDA in the First Month in the High-Risk Preterm Neonate
Clinical Management
Consider:
- Fluid restriction
- Increasing PEEP
- Maintain Hgb > 12 mg/dl
- Enteral Feedings
Stable Findings
Continue to monitor
Continue to monitor
Discharge
Cardiology follow-up recommended if ductus remains patent
Cardiology follow-up recommended if ductus remains patent
Obtain Echocardiogram
Echocardiogram Staging
Echocardiogram Staging
Persistent or worsening
Clinical Assessment
Clinical Assessment
Echo: Small/Moderate PDA
Clinical Management
Enteral Feedings
Enteral Feedings
Worsening
Clinical Assessment
Clinical Assessment
Stable findings
Continue to monitor
Continue to monitor
Echo: Large PDA
Worsening Clinical Assessment Consider repeat Echo
Consider Second
Pharmacological Treatment
Pharmacological Treatment
Persistent or worsening
Clinical Assessment
Clinical Assessment
Repeat Echo
Echocardiogram Staging
Echocardiogram Staging
Posted: April 2016
Last Revised: December 2024
Last Revised: December 2024
Evidence
- Paracetamol (Acetaminophen) for Patent Ductus Arteriosus in Preterm or Low Birth Weight Infants
- CNBCN PDA Management Prospective Audit Form
- Ibuprofen for the Treatment of Patent Ductus Arteriosus in Preterm or Low Birth Weight (or Both) Infants
- The Definition of a Hemodynamic Significant Duct in Randomized Controlled Trials: a Systematic Literature Review
- Towards Rational Management of the Patent Ductus Arteriosus: the Need for Disease Staging
- Prophylactic Indomethacin and Intestinal Perforation in Extremely Low Birth Weight Infants
- Feeding Preterm Neonates with Patent Ductus Arteriosus (PDA): Intestinal Blood Flow Characteristics and Clinical Outcomes
- Tolerance to Early Human Milk Feeding is Not Compromised by Indomethacin in Preterm Infants with Persistent Ductus Arteriosus
- Patent Ductus Ateriosus in Preterm Infants