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PDA closure – preterm — RACP Paediatrics MCQ

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ModerateCardiologyPDA closure – pretermRACP Paediatrics

A premature infant (26 weeks) at day 5 has a haemodynamically significant PDA causing increasing ventilatory requirements and pulmonary overcirculation. Conservative management has failed. Which pharmacological agent has the most evidence for PDA closure in preterm infants?

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Correct answer: C — Ibuprofen to close the duct

Ibuprofen (IV or oral) is widely used for pharmacological PDA closure in preterm infants and has equivalent efficacy to indomethacin with fewer renal side effects. Paracetamol (IV or oral) is an emerging alternative, particularly when ibuprofen is contraindicated. Timing and patient selection remain debated.

Reference: RCH Melbourne – 2023 – PDA CPG; RACP Paediatric Curriculum – Neonatology