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Comparison of standard versus high-dose ibuprofen for the treatment of hemodynamically significant patent ductus arteriosus in preterm infants

Journal of Perinatology volume 41, pages 1142–1148 (2021)Cite this article

Subjects

Abstract

Objective

To evaluate the effectiveness and safety of standard vs. high-dose ibuprofen for the treatment of hemodynamically significant patent ductus arteriosus(hs-PDA).

Study design

A retrospective study of preterm infants who received either standard (10–5–5 mg/kg/day) or high (postnatal age 1–3 days: 10–5–5 mg/kg/day; 3–5 days: 15–7.5–7.5 mg/kg/day; >5 days: 20–10–10 mg/kg/day) dose ibuprofen for hs-PDA was conducted.

Result

Sixty preterm infants with a mean birthweight of 898.2 (±262.6) g and mean gestational age of 26.3 (±0.6) weeks were included. High-dose ibuprofen was associated with a 21%(95% CI, −1.87 to 39.06%; p = 0.07) absolute reduction in PDA ligation compared to standard-dose ibuprofen. On adjusted analysis, receipt of standard-dose ibuprofen (OR 7.37, 95% CI, 1.2–45.27; p = 0.03) independently predicted increased PDA ligation risk. There were no differences in oliguria, NEC, or BPD between groups.

Conclusion

High-dose ibuprofen may significantly reduce PDA ligations. No difference in the safety profile with high-dose ibuprofen as compared to the standard-dose regimen was demonstrated.

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Fig. 1: PDA: Patent ductus arteriosus; hs-PDA: Hemodynamically signficant patent ductus arteriosus.

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Acknowledgements

I would like to thank Dr. Michael Vincer and Dr. Jehier Afifi for their help in acquiring clinical outcome data from the AC Allen Database of the Perinatal Follow-up Program, IWK Health Centre, Halifax.

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Authors and Affiliations

  1. Dalhousie College of Pharmacy, Dalhousie University, Halifax, NS, Canada

    Katelyn Hillier, Karlee Jones & Melanie MacInnis

  2. Department of Pharmacy, IWK Health Centre, Halifax, NS, Canada

    Katelyn Hillier, Karlee Jones & Melanie MacInnis

  3. Department of Pharmacy, Nova Scotia Health Authority, Halifax, NS, Canada

    Katelyn Hillier

  4. Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Dalhousie University and IWK Health Centre, Halifax, NS, Canada

    Souvik Mitra

  5. Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada

    Souvik Mitra

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  1. Katelyn Hillier
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Correspondence to Souvik Mitra.

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Hillier, K., Jones, K., MacInnis, M. et al. Comparison of standard versus high-dose ibuprofen for the treatment of hemodynamically significant patent ductus arteriosus in preterm infants. J Perinatol 41, 1142–1148 (2021). https://doi.org/10.1038/s41372-021-01046-1

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