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Conservative PDA Management — RACP Paediatrics MCQ

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ModerateNeonatologyConservative PDA ManagementRACP Paediatrics

A preterm infant at 29 weeks develops signs of a haemodynamically significant PDA at day 3. Before considering pharmacological closure, what conservative measures should be trialled?

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Correct answer: E — Fluid restriction, respiratory support optimisation, and permissive approach

Conservative management of PDA includes fluid restriction (120-140 mL/kg/day), PEEP optimisation, and expectant management. Many PDAs close spontaneously. Pharmacological closure (ibuprofen, paracetamol) is reserved for haemodynamically significant PDAs failing conservative measures. Routine prophylactic treatment of all PDAs is no longer recommended.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: PDA