N/IICU Clinical Pathway for the Management of PDA in the First Month in the High-Risk Preterm Neonate
- Related Pathways
- Perioperative Care, Newborns/Infants — ICU and Inpatient
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
Revised: June 2020
Authors: S. Ghavam, MD; J. Stoller, MD; H. French, MD; L. Christ, MD; L. Fong de Leon, MD; N. Brutus, DO; J. Cohen, MD; B. Asiegbu, MD; J. Tioseco, MD; C. Muhumza, MD; S. Grayson, MD; K. Myers, MD; M. Curtis-Cohen, MD; T. Mollen, MD; M. Cohen, MD; J. Carroll, RN, MSN
Revised: June 2020
Authors: S. Ghavam, MD; J. Stoller, MD; H. French, MD; L. Christ, MD; L. Fong de Leon, MD; N. Brutus, DO; J. Cohen, MD; B. Asiegbu, MD; J. Tioseco, MD; C. Muhumza, MD; S. Grayson, MD; K. Myers, MD; M. Curtis-Cohen, MD; T. Mollen, MD; M. Cohen, MD; J. Carroll, RN, MSN
Evidence
- CNBCN PDA Management Prospective Audit Form
- AAP Clinical Guidance PDA preemies Enteral feeding during indomethacin and ibuprofen treatment of a patent ductus arteriosus
- 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 arteriosus in preterm infants
- PDA: General Information
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