Abstract
Background/aims: Since December 2002 we use ibuprofen to treat PDA. Success rates, however, were lower than expected. We therefore compared efficacy and side effects of ibuprofen in very low birth weight infants to a historical control group treated with indomethacin.
Methods: Charts of all infants < 1500g admitted from 1.1.2000 to 1.3.2005 were reviewed. Infants mechanically ventilated on day 3 of life, with echocardiographically confirmed PDA received indomethacin (3 x 0.2 mg/kg in 12 hours intervals; time period 1: before 1.12.2002) or ibuprofen (10; 5; 5 mg/kg in 24 hours intervals; time period 2. after 1.12.2002), respectively.
Results: Fifty-three (25%) of 214 infants born in time period 1 were treated with indomethacin. Median birth weight 830 g (380 - 1460), gestational age 26 wks (22 - 31). Fifty-six (36%) of 155 infants were treated with ibuprofen. Median birth weight 895 g (355 - 1430), gestational age 26 wks (23 - 30). Closure rates with first treatment cycle were 60% (indomethacin) and 34% (ibuprofen) (p=0.005). Surgical ligation was performed in 7% of infants during time period 1 versus 14% in time period 2 (p=0.02). Temporary oliguria/anuria occurred in 19% of infants in the indomethacin and in 11% in the ibuprofen treatment group. Focal intestinal perforation or NEC with perforation occurred during time period 1 in 4/53 infants treated with indomethacin and in 7/139 infants not treated, in time period 2 in 2/56 infants treated with ibuprofen and in no infant without treatment.
Conclusion: Ibuprofen was less effective than indomethacin in closing the PDA in very low birth weight infants in our centre. Need for surgical ligation was twice as high following ibuprofen treatment. The difference to results of other centres may be explained by extreme prematurity of our population.
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Hüning, B., Tietze, N., Kutz, P. et al. 177 Treatment of Ductus Arteriosus in Very Low Birth Weight Infants: Ibuprofen Versus Indomethacin. Pediatr Res 58, 385 (2005). https://doi.org/10.1203/00006450-200508000-00206
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DOI: https://doi.org/10.1203/00006450-200508000-00206