This document discusses treatment options for a patent ductus arteriosus (PDA). It recommends waiting up to 2 years for spontaneous closure of a moderate PDA, but intervening earlier if symptoms of congestive cardiac failure or infective endocarditis are present. Medical management with indomethacin or ibuprofen is indicated for preterm babies or those likely to close spontaneously. Interventional procedures using an umbrella device are recommended for term babies with PDA and cardiac failure who do not respond to medical treatment. Surgical closure involving double ligation of the PDA is indicated for small infants or preterm babies with a large PDA.

1. TREATMENT

2. Ideal age for intervention:
• Small PDA wait & follow till spontaneous
closure
• Moderate PDA wait upto 2yrs or till baby is
10kg
• If PDA is present with symptoms like CCF or
infective endocarditis SURGICAL
intervention( closure of PDA)

3. Medical Management
Indicated when PDA is preterm baby or is likely
to close spontaneously:
• Indomethacin: 0.1-0.2mg/kg 12 hourly for 3
doses( most effective in pre terms). Started
48-72 hrs within birth. It acts by reducing PGE.
• Ibuprofen: given in baby with renal problem

4. Treatment of associated conditions
CARDIAC FAILURE:
• Avoid fluid overload( fluid restriction)
• Diuretics
• Digoxin

5. INTERVENTIONAL Procedures
• Indicated when term baby, PDA with CCF,
failure of medical measures
• Optimal age: 1st year of life
• It involves non surgical closure using
UMBRELLA device using transcatheter method
• C/I: high pulm. Artery pressure, Eisenmenger’s
syndrome

6. SURGICAL CLOSURE
• Indications: small infant with large PDA, pre
term.
• Double ligation of PDA

7. Baby is on the following:
• i.v. Isolyte P (18ml/hr)
• Syrup Digoxin (0.5ml BD)
• Syp. Maclar (1.3 ml BD)
• Syp. Calpol (2ml ;SOS)
• Tab. Lasilactone (12.5mg OD)
• Nebulisation with Levolin
• Tab. Envas (2.5mg; 0.5ml-0-0.5ml)