Abstract
Background: Since studies have shown equal efficiency and less side effects of Ibuprofen compared to Indomethacin, Ibuprofen became the preferential substance for the treatment of ductus arteriosus in preterm infants at many centres. We present our experiences since we have changed from Indomethacin to Ibuprofen in December 2002.
Methods: From December 2002 to March 2004 99 preterm infants < 1500g were admitted to our centre. All infants, mechanically ventilated on day 3 of life, with echocardiographically confirmed patent ductus arteriosus (regardless of ductal diameter or shunt velocity) received Ibuprofen in three intravenous doses (10; 5; 5 mg/kg) in 24 hours intervals. Forty-one infants were treated, starting on day 3 - 14 of life. The birth weight ranged from 355 – 1230g (810g), gestational age 23–29 weeks (median 26 weeks). Eleven of 54 (20%) infants with birth weight 1000 – 1500g (VLBW) and 30 of 55 (55%) infants < 1000g (ELBW) were treated with Ibuprofen.
Results: In the group of VLBW infants the ductus closed in 6 of 11 patients (55%) after the first course of Ibuprofen. Two infants (18%) received a second cycle of Ibuprofen, one patient (9%) needed surgery. In 8 of 30 (27%) ELBW infants ductal closure was achieved after the first cycle of Ibuprofen. Eleven infants (37%) were treated with a second cycle and 11 (37%) needed surgical ductus ligation. Anuria was not observed. Three infants exhibited oliguria during the first 24 hours after the start of treatment. An increase in creatinine serum levels of > 0.3 mg/dl from baseline was occurred in 5 infants. Two infants developed NEC 4 and 6 days after the start of treatment with Ibuprofen, respectively. Oxygen demand did not change significantly during ibuprofen treatment.
Conclusion: Ibuprofen treatment was well tolerated in very low birth weight infants. However, the number of infants who needed surgery was high in the group of infants with birth weight < 1000g (20% of all ELBW infants).
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Huening, B., Roll, C. 114 Treatment of Patent Ductus Arteriosus with Ibuprofen in Very Low Birth Weight Infants. Pediatr Res 56, 483 (2004). https://doi.org/10.1203/00006450-200409000-00137
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DOI: https://doi.org/10.1203/00006450-200409000-00137