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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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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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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DOI: https://doi.org/10.1038/s41372-021-01046-1