June 2026. Volume 22. Number 2

Doubts are raised about the benefit of active treatment of the ductus arteriosus in very premature infants

 
 
 
 
 
 
 
 
 
 
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AVC | Critically appraised articles

Buvaneswarran S, Wong YL, Liang S, Quek SC, Lee J. Active Treatment vs Expectant Management of Patent Ductus Arteriosus in Preterm Infants: A Meta-Analysis. JAMA Pediatr. 2025;179:877-85.

Reviewers: Carvajal Encina F1, Blanco Rodríguez C2.
1Unidad del Paciente Crítico Neonatal. Hospital La Serena. Universidad Católica del Norte. Coquimbo. Chile.
2Pediatra. CS Sanchinarro. Madrid. España.
Correspondence: Fernando Carvajal Encina. Email: fcarvajale@gmail.com
Reception date: 26/03/2026
Acceptance date: 01/04/2026
Publication date: 15/04/2026

Abstract

Authors ́ conclusions: active treatment of hemodynamically significant ductus arteriosus in premature infants during the first two weeks of life was associated with increased morbidity and mortality.

Reviewers ́ commentary: the results of the meta-analysis show an increase in mortality among treated patients which, although modest, is clinically relevant. Routine early pharmacological treatment should be avoided in all preterm infants with patent ductus arteriosus, and an expectant management strategy should be preferred, except in cases with clear signs of hemodynamic compromise. Further research is needed on precise echocardiographic criteria, specific subgroups that may benefit, and more selective interventions.

How to cite this article

Carvajal Encina F, Blanco Rodríguez C. Se plantean dudas sobre el beneficio del tratamiento activo del ductus arterioso en grandes prematuros. Evid Pediatr. 2026;22:12.

AVC | Critically appraised articles

Buvaneswarran S, Wong YL, Liang S, Quek SC, Lee J. Active Treatment vs Expectant Management of Patent Ductus Arteriosus in Preterm Infants: A Meta-Analysis. JAMA Pediatr. 2025;179:877-85.

Reviewers: Carvajal Encina F1, Blanco Rodríguez C2.
1Unidad del Paciente Crítico Neonatal. Hospital La Serena. Universidad Católica del Norte. Coquimbo. Chile.
2Pediatra. CS Sanchinarro. Madrid. España.
Correspondence: Fernando Carvajal Encina. Email: fcarvajale@gmail.com
Reception date: 26/03/2026
Acceptance date: 01/04/2026
Publication date: 15/04/2026

How to cite this article

Carvajal Encina F, Blanco Rodríguez C. Se plantean dudas sobre el beneficio del tratamiento activo del ductus arterioso en grandes prematuros. Evid Pediatr. 2026;22:12.

15/04/2026

Linked Comment

Methodological note