{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T02:45:52Z","timestamp":1790390752553,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2011,10,6]],"date-time":"2011-10-06T00:00:00Z","timestamp":1317859200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2012,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Aim:\u2002<\/jats:bold> A patent ductus arteriosus (PDA) is associated with morbidity in preterm infants. Treatment is prescribed for a haemodynamically significant duct (HSDA), but its definition varies. We systematically reviewed the clinical and ultrasound criteria used for the definition of an HSDA.<\/jats:p><jats:p><jats:bold>Methods:\u2002<\/jats:bold> PubMed and the Cochrane library were searched for randomized trials evaluating ductal treatment. The included studies were explored, and we categorized clinical and ultrasound criteria used to define an HSDA.<\/jats:p><jats:p><jats:bold>Results:\u2002<\/jats:bold> Sixty\u2010seven trials were included in our review. Forty\u2010two were placebo\u2010controlled trials, and 25 were comparative trials. The diagnosis of the PDA was made by clinical examination, followed by ultrasound in most trials. Most trials used clinical and ultrasound criteria to define an HSDA, but there was a wide variety in criteria and cut\u2010offs used. Of the clinical criteria, a murmur or hyperdynamic circulation was most used, and of the ultrasound criteria, the left\u2010atrium\u2010to\u2010aorta ratio (LA\/Ao ratio) was most used.<\/jats:p><jats:p><jats:bold>Conclusion:\u2002<\/jats:bold> We found a wide variety in the definition of an HSDA. This finding implies that comparison of studies is difficult. International consensus should be reached on the definition of an HSDA, which will make future studies more comparable.<\/jats:p>","DOI":"10.1111\/j.1651-2227.2011.02468.x","type":"journal-article","created":{"date-parts":[[2011,9,14]],"date-time":"2011-09-14T05:36:13Z","timestamp":1315978573000},"page":"247-251","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":127,"title":["The definition of a haemodynamic significant duct in randomized controlled trials: a systematic literature review"],"prefix":"10.1111","volume":"101","author":[{"given":"Inge","family":"Zonnenberg","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koert","family":"de Waal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2011,10,6]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2006.12.048"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.2006.tb02251.x"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD003745"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD000174.pub2"},{"key":"e_1_2_7_6_2","first-page":"CD003481","article-title":"Ibuprofen for the treatment of patent ductus arteriosus in preterm and\/or low birth weight infants","volume":"14","author":"Ohlsson A","year":"2010","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_7_2","first-page":"CD004213","article-title":"Ibuprofen for the prevention of patent ductus arteriosus in preterm and\/or low birth weight infants","volume":"3","author":"Shah SS","year":"2006","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_8_2","first-page":"CD003951","article-title":"Surgical versus medical treatment with cyclooxygenase inhibitors for symptomatic patent ductus arteriosus in preterm infants","volume":"1","author":"Malviya M","year":"2008","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_9_2","first-page":"CD006181","article-title":"Prophylactic surgical ligation of patent ductus arteriosus for prevention of mortality and morbidity in extremely low birth weight infants","volume":"1","author":"Mosalli R","year":"2008","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_10_2","first-page":"CD003480","article-title":"Prolonged versus short course of indomethacin for the treatment of patent ductus arteriosus in preterm infants","volume":"2","author":"Herrera C","year":"2007","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2006.11.039"},{"key":"e_1_2_7_12_2","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2010.3"},{"key":"e_1_2_7_13_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0028-1103515"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2004-1178"},{"key":"e_1_2_7_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)17476-X"},{"key":"e_1_2_7_16_2","first-page":"314","article-title":"Oral ibuprofen prophylaxis for symptomatic patent ductus arteriosus of prematurity","volume":"89","author":"Sangtawesin V","year":"2006","journal-title":"J Med Assoc Thai"},{"key":"e_1_2_7_17_2","first-page":"S28","article-title":"Prophylaxis of symptomatic patent ductus arteriosus with oral ibuprofen in very low birth weight infants","volume":"91","author":"Sangtawesin C","year":"2008","journal-title":"J Med Assoc Thai"},{"key":"e_1_2_7_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)17477-1"},{"key":"e_1_2_7_19_2","unstructured":"Australian New Zealand Clinical Trials Registry.Targeting of treatment of the patent ductus arteriosus using early echocardiography (DETECT). 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