{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T15:58:46Z","timestamp":1783612726070,"version":"3.55.0"},"reference-count":28,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:p>\n            Objective\u2003The study aimed to investigate, whether expectant management is noninferior to early patent ductus arteriosus (PDA) treatment with regard to the composite of mortality and\/or incidence of bronchopulmonary dysplasia (BPD) in very preterm infants.<\/jats:p><jats:p>\n            Study design\u2003A total of 208 very preterm infants of the gestational age &lt;32 weeks, birth weight &lt;1,500\u2009g, chronological age &lt;72\u2009hours, and PDA &gt;1.5\u2009mm were randomized between the treatment or expectant management groups. Both, the intention-to-treat and per-protocol analyses were performed.<\/jats:p><jats:p>\n            Results\u2003A total of 104 (50%) patients received rectal ibuprofen (n\u2009=\u200952) or intravenous acetaminophen (n\u2009=\u200952) within first 72\u2009hours of life. In 104 (50%) infants, expectant management was used. Eight of them (8%) received rescue treatment at the median age of 7 (range: 6\u201313) days. PDA closure rates by the 10th day of life were 81% (n\u2009=\u200984) in the treatment arm, and 58% (n\u2009=\u200960) in the expectant management arm (p\u2009&lt;\u20090.01). The median age at the time of ductus closure was 5 (range: 5\u20136) days in the treatment arm and 8 (range: 6\u201311) days in the expectant management arm (p\u2009&lt;\u20090.01). At the time of discharge, ductus was closed in 83% of treated infants and in 78% of patients who were managed expectantly (p\u2009&gt;\u20090.05). No significant difference between the groups was found for the primary clinical outcomes, BPD\/death, or the secondary outcomes at a postmenstrual age of 36 weeks or discharge.<\/jats:p><jats:p>\n            Conclusion\u2003Expectant management is noninferior to early PDA treatment for reducing the incidence of death\/BPD. Compared with the expectant management, early pharmacological treatment provides more frequent and faster PDA closure in preterm infants with gestational age &lt;32 weeks, but it neither reduces morbidity nor improves survival rates.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/a-1782-5860","type":"journal-article","created":{"date-parts":[[2022,2,26]],"date-time":"2022-02-26T00:24:01Z","timestamp":1645835041000},"page":"730-738","source":"Crossref","is-referenced-by-count":18,"title":["Randomized Noninferiority Trial of Expectant Management versus Early Treatment of Patent Ductus Arteriosus in Preterm Infants"],"prefix":"10.1055","volume":"41","clinical-trial-number":[{"clinical-trial-number":"nct03860428","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0772-0724","authenticated-orcid":false,"given":"Solomiia","family":"Potsiurko","sequence":"additional","affiliation":[{"name":"Department of Pediatrics No. 2, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4114-8701","authenticated-orcid":false,"given":"Dmytro","family":"Dobryanskyy","sequence":"additional","affiliation":[{"name":"Department of Pediatrics No. 2, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lesya","family":"Sekretar","sequence":"additional","affiliation":[{"name":"Department of Pediatrics No. 2, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoryana","family":"Salabay","sequence":"additional","affiliation":[{"name":"The Neonatal Intensive Care Unit of the Lviv Regional Clinical Hospital, Lviv, Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,4,18]]},"reference":[{"issue":"06","key":"ref1","doi-asserted-by":"crossref","first-page":"F505","DOI":"10.1136\/archdischild-2013-303816","article-title":"Morbidity and mortality in preterm neonates with patent ductus arteriosus on day 3","volume":"98","author":"A Sellmer","year":"2013","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1111\/chd.12708","article-title":"PDA: to treat or not to treat","volume":"14","author":"M N Sankar","year":"2019","journal-title":"Congenit Heart Dis"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.jpeds.2016.06.046","article-title":"Mandatory closure versus nonintervention for patent ductus arteriosus in very preterm infants","volume":"177","author":"S I Sung","year":"2016","journal-title":"J 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