Management of patent ductus arteriosus - Evidence to practice.

Over the past last 50 years, patent ductus arteriosus (PDA) continues to be the leading hot topic debated worldwide in search of best treatment approach and the uncertainty around whether to treat or not treat a PDA. With the availability of bedside echocardiography and the increasing number of neonatologists acquiring this skill, on one hand there is better understanding of PDA physiology during transitional circulation and objectivity in management, but on the other hand clinicians are uncertain about benefits in health outcomes. Evidence from recent trials utilizing early selective treatment guided by bedside echocardiography should help in dispelling some myths if not providing the answer about how to manage the PDA.

Ethical and Legal Perspectives on the Treatment of Hypoxic Ischemic Encephalopathy in the Newborn.

Hypoxic ischemic encephalopathy (HIE) in neonates can cause severe, life-long functional impairments or death. Treatment of these neonates can involve ethically challenging questions about if, when, and how it may be appropriate to limit life-sustaining medical therapy. Further, parents whose infants suffer severe neurologic damage may seek recourse in the form of a medical malpractice lawsuit.