Abstract
Background: Intraventricular hemorrhage (IVH) remains a frequent complication in preterm infants and this point is crucial because the most severe IVH are related to a high risk of neurodevelopmental handicaps. Ibuprofen enhances cerebral blood flow autoregulation and has been shown to protect neurological functions following oxidative stresses in an animal model. For these reasons we hypothesized that the prophylactic use of ibuprofen would reduce the occurrence of IVH.
Methods: We studied 155 infants with gestational age less than 28 weeks. The infants were randomly assigned at seven neonatal care units to receive ibuprofen (10 mg/kg, within 6 hours of life, followed by 5 mg/kg after 24 and 48 hours) or placebo. Serial echoencephalography was performed 24 and 48 hours after the initial cerebral ultrosound, on postnatal day 7, 15, 30 and at 40 weeks postconceptional age. Grade 1 IVH or no IVH was considered a successful outcome, while grade 2 to 4 represented failure. The rate of ductal closure, side effects, and complications were recorded.
Results: Grades 2 to 4 IVH developed in 16% of the ibuprofen-treated infants and in 13% of the placebo group (p0.05). The occurrence of PDA was less frequent only on the 3rd day of life in ibuprofen group. There were no significant differences with respect to other complications or adverse effects.
Conclusions: Our study demonstrated that prophylactic ibuprofen is ineffective in preventing grade 2–4 IVH and that its use cannot be recommended for this indication. á
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Dani, C., Bertini, G., Pezzati, M. et al. 57 Prophylactic Ibuprofen for The Prevention of Intraventricular Hemorrhage in Preterm Infants: A Multicenter Randomized Study. Pediatr Res 56, 473 (2004). https://doi.org/10.1203/00006450-200409000-00080
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DOI: https://doi.org/10.1203/00006450-200409000-00080