Decrease in the frequency of treatment for patent ductus arteriosus after implementation of consensus guidelines: a 15-year experience

Backgroundpatent ductus arteriosus (pda) management varies widely among neonatologists.local problemlack of institution-specific evidence-based guidelines for therapeutic closure of pda.methodsquality improvement project among infants <30 weeks gestational age (ga) designed to determine whether the odds of therapy for closing the pda, adjusted for ga, decreased after implementing evidence-based guidelines.interventionimplementation of guidelines with conservative approach to pda management.resultsthe frequency of pda treatment decreased from 446/1125 (40%) in epoch 1 to 96/482 (20%) in epoch 2. pda treatment was more frequent in neonates 23–26 weeks ga than those of 27–29 weeks ga (43% vs. 28%, respectively). among 542 infants receiving indomethacin for pda, 25% had subsequent ligation; the odds of ligation after indomethacin were lower in neonates 27–29 weeks ga and decreased during epoch 2.conclusionsthe frequency of medical and surgical treatment for therapeutic closure of pda decreased after implementing evidence-based treatment guidelines.