Abstract
Patent ductus arteriosus (PDA) in premature neonates is less likely to close spontaneously comparing to full-term infants. Pharmacological treatment with nonsteroidal anti-inflamatory drugs are mainly used for closure of PDA. Although the use of Ibuprofen (IBU) in PDA treatment have not yet been examined in detail the aim of this study was to evaluate the efficacy of IBU therapy in premature infants (<34 weeks of gestation) treated for PDA.
Materials and methods: Thirty five neonates neonates born between 25–33 weeks of gestation (mean 29+/-2.5 weeks) and with birth weights between 820-2090g at birth (mean 1338.3+/-380.5g) were enrolled into the study. All infants were diagnosed as having hemodynamically significantPDA confirmed by ECHO between 3rd and 7th day of life. Intravenous IBU (first dose of 10mg/kg followed by next doses of 5mg/kg at 24-hour intervals) was administred by a 15 minute intravenous infusions. The patients serum platelet counts were >60,000uL and blood urea nitrogen <40mg/dL. Head ultrasound, enteral feeding tolerance, urine output were assesed before and after IBU.
Results: IBU was administered at mean 5.8+1.3 days of life. Mean size of PDA was 2+/-0.8 mm. In 31 of 35 patients (88.6%) PDA was closed after IBU therapy. 3 neonates (8.6%) with a clinically closed ductus developed a recurrent, symptomatic PDA and 2 of them needed surgical ligation. The treatment was ineffective in 4 infants (11.4%) of which 3 neonates underwent surgical ligation. Pulmonary hemorrhage occured in one patient and another one showed gastric hemorrhage. Twenty infants (57%) were enterally fed during the treatment. We have not shown an increase in the incidence of necrotizing enterocolitis, IVH, renal failure and bleeding from puncture sites.
Conclusions: Our findings suggest that IBU is of high efficacy when used for PDA tratment in neonates < 34 weeks of gestation. The treatment had no influence on incidence of intraventricular hemorrhage and did not impaire food tolerance and urine output.
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Witoslaw, B., Szymankiewicz, M. & Gadzinowski, J. 133 Efficacy of Ibuprofen for Treatment of Patent Ductus Arteriosus (PDA) in Neonates < 34 Weeks of Gestation. Pediatr Res 58, 377 (2005). https://doi.org/10.1203/00006450-200508000-00162
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DOI: https://doi.org/10.1203/00006450-200508000-00162