PDA Stenting for Ductal-Dependent Pulmonary Blood Flow: Management of Prostaglandin E1 Infusion

Newborns with ductal-dependent pulmonary blood flow require PGE1 infusion prior to ductal stenting to ensure patency of the PDA. There is no consensus, however, on management of PGE in the peri-procedural period in terms of timing of discontinuation of the drug. This review will focus on the rationale for continuing or discontinuing PGE, a brief review of some of the published recommendations, and will make some final recommendations regarding PGE management. Reasons to continue PGE include ensuring the patient is stable and has adequate oxygenation prior to the stenting procedure. In addition, continuation of PGE makes the procedure logistically easier since the timing for the intervention is not dependent upon ductal constriction. The rationale for discontinuation of PGE is to ensure there is adequate ductal constriction to securely place a stent and minimize the risk of stent embolization. Decision-making regarding the discontinuation of PGE must be individualized and is primarily dependent upon PDA morphology.