scholarly journals ORAL VERSUS INTRAVENOUS IBUPROFEN FOR THE EARLY CLOSURE OF PATENT DUCTUS ARTERIOSUS IN LOW BIRTH WEIGHT PRETERM INFANTS

2013 ◽  
Vol 6 ◽  
Author(s):  
Alketa Hoxha ◽  
Ermira Kola ◽  
Numila Kuneshka ◽  
Eduard Tushe
Keyword(s):  
Birth Weight ◽  
Adverse Effects ◽  
Preterm Infants ◽  
Premature Infants ◽  
Ductus Arteriosus ◽  
Ductal Closure ◽  
Oral Ibuprofen ◽  
Intravenous Ibuprofen ◽  
Ibuprofen Group ◽  
Patent Ductus

Background Patent ductus arteriosus (PDA) is common in very premature infants. Pharmacological closure of PDA with indomethacin, a prostaglandin inhibitor, has remained the mainstay of treatment in premature infants over the last three decades. Intravenous ibuprofen was recently shown to be as effective and to have fewer adverse reaction in preterm infants. If equally effective, then oral ibuprofen for PDA closure would have several important advantages over the intravenous route.This study was designed to assess the efficacy and safety of oral ibuprofen and intravenous ibuprofen for the early pharmacological treatment of PDA in LBW preterm infants with respiratory distress syndrome.MethodsA randomized, single-blinded, controlled study was performed on premature neonates at the neonatal care unit of the University Hospital for Obstetrics and Gynecology”Koco Gliozheni”, Tirana, Albania, from January 2010 to December 2012. The study enrolled 68 preterm infants with gestational age between 28-32 weeks, birth weight ≤ 2000 g, postnatal age 48-96 h, and had echocardiographically confirmed significant PDA. The preterm infants received either intravenous or oral ibuprofen randomly as an initial dose of 10 mg/kg, followed by 5 mg/kg at 24 and 48 h. After the first dose of treatment in both groups, echocardiographic evaluation was performed, to determine the need for a second or third dose. The rate of ductal closure, adverse effects, complications, and the patient’s clinical course were recorded.Results All patients were born after 28 until 32 weeks’ gestation. 36 patients were treated with oral ibuprofen and 32 with intravenous ibuprofen in this period. After the first course of the treatment, the PDA closed in 30 (83.3%) of the patients assigned to the oral ibuprofen group versus 23 (71.8%) of those enrolled in the intravenous ibuprofen group (p = 0.355). There was no difference between treatment groups in demographics or baseline renal function. In the evaluation of renal tolerance, none of the patients had oliguria. There were no significant differences with respect to complications during the stay.Conclusions In low birth weight infants, the rate of early ductal closure with oral ibuprofen is at least as good as with the intravenous route.  Oral ibuprofen is associated with fewer adverse effects

scholarly journals Paracetamol vs Ibuprofen in Hemodynamically Significant Patent Ductus Arteriosus (HsPDA) in Preterms: A Randomized Controlled Trial

2020 ◽  
pp. 6-13
Author(s):  
Hinal A. Sinol ◽  
Alpa N. Parekh ◽  
Jayendra R. Gohil ◽  
Mehul Gosai
Keyword(s):  
Adverse Effects ◽  
Patent Ductus Arteriosus ◽  
Preterm Infants ◽  
Discharge Rate ◽  
Controlled Trial ◽  
Ductus Arteriosus ◽  
Preterm Neonates ◽  
Ductal Closure ◽  
Ibuprofen Group ◽  
Patent Ductus

Background and Objective: Hemodynamically significant patent ductus arteriosus (HsPDA) is a common cause of morbidity in preterm infants. Indomethacin and Ibuprofen, which are cyclo-oxygenase (COX) 1, 2 inhibitors are commonly used drugs for closure of HsPDA. As, Ibuprofen has several contraindications, we designed study using oral paracetamol (a peroxidase inhibitor) and compared with oral ibuprofen, for efficacy and safety in relation to closure of HsPDA in preterm infants. Methods: 140 preterm infants (gestational age less than 32 weeks) with HsPDA (confirmed by 2D Echo) were randomly assigned in two groups and received first course of either oral paracetamol (70) or ibuprofen (70). The need for a second course was determined by 2D Echo evaluation. Parameters studied were rate of ductal closure, any adverse effects and discharge rate. Results: Both groups were similar in term of ductal closure after first course (p=0.46) and second course (p=0.59). However, 22 from Ibuprofen group and only 2 from PCM group developed adverse effects (p<0.001). From paracetamol group 58 were discharged, and 12 died; while from ibuprofen group 46 discharged, 24 died (p=0.03). Conclusion: Paracetamol for HsPDA in preterm neonates was associated with good efficacy and better safety; and less deaths, as compared to ibuprofen.

scholarly journals Prevalence of patent ductus arteriosus in premature infants at the Neonatal Ward, Cipto Mangunkusumo Hospital, Jakarta

2016 ◽  
Vol 44 (6) ◽  
pp. 223 ◽  
Author(s):  
Benita Deselina ◽  
Sukman Tulus Putra ◽  
Rulina Suradi
Keyword(s):  
Birth Weight ◽  
Incidence Rate ◽  
Preterm Infants ◽  
Premature Infants ◽  
Gestational Age ◽  
Heart Diseases ◽  
Ductus Arteriosus ◽  
Chronological Age ◽  
Neonatal Ward ◽  
Patent Ductus

Background Patent ductus arterious (PDA) is one of the mostcommon congenital heart diseases encountered in preterm infants.The lower the birth weight and gestational age are, the higher theincidence of PDA is.Objectives To investigate the incidence of PDA in premature infantshospitalized in the neonatal wards of Cipto Mangunkusumo Hospitalusing echocardiography.Methods Preterm infants born between August and October 2003were included in this study. Clinical features were retrieved from medicalcharts. The first echocardiography was conducted on all of the preterminfants at the chronological age of 3 days. If PDA was detected,echocardiography was repeated at the chronological age of 6 days.Results During the 3-month period, sixty-five preterm infantsparticipated in this study and underwent echocardiography. In thefirst echocardiogram, the incidence rate of PDA was 32%. Atgestational age of less than 28 weeks, 1 of 2 infants had PDA. Of 3infants with birth weight of more than 1000 grams, 2 had PDA. Onthe second echocardiography, the incidence rate of PDA was 14%and mostly found in infants at gestational age of less than 28 weeks(8/9) and in those with birth weight of less than 1000 grams (7/9).All infants with RDS whose PDA was identified in the firstechocardiography proved to maintain their PDA in the secondechocardiography.Conclusion The incidence rate of PDA in preterm infants was14%. The lower the birth weight, the higher the incidence rate ofPDA. The presence of RDS is related to the delay in the closing ofthe arterial duct

scholarly journals Ligation of patent ductus arteriosus in very low birth weight premature infants

2020 ◽  
Vol 61 (4) ◽  
pp. 399-405
Author(s):  
Hasan F. Othman ◽  
Debra T. Linfield ◽  
Mohamed A. Mohamed ◽  
Hany Aly
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Patent Ductus Arteriosus ◽  
Premature Infants ◽  
Very Low Birth Weight ◽  
Ductus Arteriosus ◽  
Patent Ductus
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