What is the critical care management approach for infants with patent ductus arteriosus (PDA)?

The critical care management approach for infants with patent ductus arteriosus (PDA) often involves pharmacological treatment as a first-line strategy, particularly with medications like indomethacin or ibuprofen. These medications are nonsteroidal anti-inflammatory drugs that work by inhibiting prostaglandin synthesis, which helps to promote the closure of the ductus arteriosus. This medical management is generally preferred because it is less invasive and can lead to successful closure of the PDA in a significant percentage of preterm infants without the need for surgery.

Surgical intervention is considered if pharmacological treatment is unsuccessful or if the infant presents with significant hemodynamic instability due to the PDA. Surgery is an option for those who need urgent intervention or for those who are not candidates for medical management.

Monitoring alone is not sufficient when dealing with a PDA that causes clinical symptoms since it can lead to complications such as heart failure, respiratory distress, and increased pulmonary flow. Corticosteroids do not play a role in managing PDA directly and are not indicated for this condition.

Therefore, the correct approach combines pharmacological treatment as the initial step, with surgery being an option if needed, making the management strategy both comprehensive and effective in addressing this common issue in neon