Congratulations to William Harvey Hospital for recruiting their 1st participant to Baby-OSCAR. Huge thanks to the team there for their effort and hard work in setting the trial up.
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A landmark for the Baby-OSCAR Trial. This is not without thanks to the families involved and our team of hard working research nurses, consultants and echocardiographers.
In commenting on results from a number of trials for PDA closure, Doff B. McElhinney has the following to say:
The issue of PDA management in preterm infants can be reduced to three fundamental questions: whether (which patients) to treat, when to treat, and how to treat. Despite extensive research and tides of enthusiasm for one perspective or another, there is no clear consensus on any of these questions [18,19], and indeed, those issues are not going to be resolved with the emergence of device closure as a therapeutic possibility. The management options other than device closure are simple: conservative management (no treatment), pharmacologic therapy with cyclo-oxygenase inhibitors, and surgical ligation, using either open or thoracoscopic approaches. However, the data and decision-making around these choices are anything but clear. There are advantages and drawbacks to each, depending on the circumstances and definitions, and this is likely to be true for device closure as well. Ultimately, the calculus is a clinical one based on both short- and longer-term outcomes, not purely on efficacy at closing the PDA. Moving forward, it is essential that trials of PDA device closure in small and preterm infants address not just technical and hemodynamic success, but also clinical outcomes, which may allow for identification of patients who are likely to benefit from PDA closure, not simply those who can undergo successful closure.
This highlights the importance of studies such as Baby-OSCAR in determining appropriate ways of managing PDA within this population. To read the full editorial, you can click here.
DOI: 10.1002/ccd.27076 Published online 8 May 2017 in Wiley Online Library (wileyonlinelibrary.com)
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