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Comment & Response |

Patent Ductus Arteriosus in Preterm Neonates—Concerns With Some Recommendations

Prakesh S. Shah, MD, MSc, FRCPC1,2; Amish Jain, MBBS, MRCPCH1,2
[+] Author Affiliations
1Department of Paediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada
2University of Toronto, Toronto, Ontario, Canada
JAMA Pediatr. 2015;169(12):1177-1178. doi:10.1001/jamapediatrics.2015.2792.
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In Reply We thank Golombek and Sola for their comments on our article.1 We completely agree with their concern regarding diuretics and particularly increased synthesis of prostaglandin following administration of furosemide2 (and not prostaglandin inhibition as mentioned in the letter). We would like to inform the readers that Figure 1 of the article1 was shown to inform readers of all therapeutic modalities used so far in the treatment of patent ductus arteriosus. In the text, it is clearly written “However, 3 RCTs [randomized clinical trials] of furosemide showed no apparent benefit,” and at no point in the article did we assert that diuretics should be used for the treatment of patent ductus arteriosus. We would like to point out that in addition to its potential for increasing ductal size, furosemide is also associated with nephrotoxic effects, and it is not recommended for the treatment of patent ductus arteriosus.3,4


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December 1, 2015
Sergio G. Golombek, MD, MPH; Augusto Sola, MD
1Division of Newborn Medicine, Department of Pediatrics and Clinical Public Health, New York Medical College, Valhalla2Maria Fareri Children’s Hospital at Westchester Medical Center, Valhalla, New York3SIBEN (Iberoamerican Society of Neonatology), Dana Point, California
3SIBEN (Iberoamerican Society of Neonatology), Dana Point, California
JAMA Pediatr. 2015;169(12):1177. doi:10.1001/jamapediatrics.2015.2789.
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