scholarly journals An Observational Study on Use of Intravenous Paracetamol for Closure of Patent Ductus Arteriosus in Newborns

2021 ◽  
Vol 2 (1) ◽  
pp. 18-21
Author(s):  
Diwas Dhungana ◽  
Manish Shrestha ◽  
Suchita Joshi
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Patent Ductus Arteriosus ◽  
Preterm Infants ◽  
Very Low Birth Weight ◽  
Ductus Arteriosus ◽  
Treatment Modalities ◽  
Preterm Neonates ◽  
Intravenous Paracetamol ◽  
Patent Ductus

Introduction: Failure or delay in spontaneous closure of ductus arteriosus is commonly seen among very low birth weight and very preterm neonates (<32 weeks), results in patent ductus arteriosus (PDA). Hemodynamically significant PDA (hs-PDA) is associated with significant morbidity and mortality if not timely intervened. At present, treatment modalities for hs- PDA remain pharmacological with nonspecific cyclo-oxygenase inhibitors such as ibuprofen/indomethacin or surgical ligation whenever pharmacological management is contraindicated. Recently, trials with prostaglandin synthase inhibitor, paracetamol are emerging as an effective treatment modality for PDA closure. In this retrospective observational cohort study, we evaluated the effectiveness of intravenous paracetamol as a first line therapy in very low birth weight infants with hemodynamically significant PDA. Methods: Twenty four preterm infants with hemodynamically significant PDA (hs-PDA) were treated with intravenous paracetamol 15mg/kg every 6 hourly and subsequent closure was evaluated clinically and by follow-up 2D-Echocardiography. The dosage of 15 mg/kg for IV paracetamol was chosen based on previously reported data for paracetamol in the treatment of PDA in preterm newborns. Results: PDA closure following intravenous paracetamol was evident in 22 preterm neonates (91.67%). There were no significant side effects noted with paracetamol therapy. Conclusions: This study concludes that intravenous paracetamol is an effective alternative for the pharmacological closure of hemodynamically significant patent ductus arteriosus in preterm infants.  

scholarly journals Role of Sequential Functional Echocardiography in Predicting Clinically Apparent Patent Ductus Arteriosus in Preterm Very Low Birth Weight Newborns-An Observational Study

2020 ◽  
Author(s):  
Anchala Bhardwaj ◽  
ARVIND SAILI ◽  
Dinesh Kumar Yadav ◽  
Ajay Kumar
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Patent Ductus Arteriosus ◽  
Left Atrial ◽  
Very Low Birth Weight ◽  
Ductus Arteriosus ◽  
Preterm Neonates ◽  
Predictive Utility ◽  
Patent Ductus

Abstract Background The management of patent ductus arteriosus in preterm neonates continues to be a topic of discussion and controversy. Prolonged ductal patency in preterm neonates has been associated with significant short and long term morbidities and with increased mortality however, policy of routine treatment of all during neonatal period has failed to show significant improvement in long term outcome. Echocardiography has emerged as a promising modality to screen the newborns at risk of adverse effects of ductal shunting. This helps in identifying PDAs that require treatment to ultimately prevent unnecessary therapy or delay of necessary therapy. There are multitude of studies that have evaluated large number of echocardiographic markers for their predictive utility but only few have included all ductal markers together in a single study. The reported sensitivity (26-100%) and specificity (6-100%) of echocardiographic markers vary over a wide range. Thus, this study was planned with an aim to assess the predictive utility of all available ductal markers and their added advantage of having all over few ones in clinically apparent PDA in preterm VLBW newborns.Methods It was an observational prospective study conducted in tertiary care NICU at Lady Hardinge Medical College, Delhi. Fifty preterm very low birth weight (VLBW) newborns underwent four sequential Echo scans within first 72 hrs; first scan within 12 hours then at 24 hrs ,48 hrs and 72 hrs of age and were monitored clinically for the signs of PDA up to two weeks of life or discharge whichever comes later.Results The Ductal diameter, pulsatile ductal flow pattern, Left pulmonary artery (LPA) velocity, Left atrial to aortic width (La/Ao) ratio, Left atrial volume index (LAVI), Left ventricle to aortic width (Lv/Ao) ratio, E/A ratio and Left ventricular output/superior vena caval (LVO/SVC) flow ratio predicted clinically apparent PDA during first 72 hours of life.Conclusion This study provides insights into the predictive utility of other ductal echo markers along with the routinely measured conventional ones during first 72 hours of life in preterm VLBW newborns.

Serial Doppler velocimetry of mesenteric and portal flow in very-low-birth-weight preterm neonates with and without patent ductus arteriosus

2020 ◽  
Vol 50 (8) ◽  
pp. 1107-1114
Author(s):  
Larissa Sobral Cavalcanti ◽  
Eduardo Just da Costa e Silva ◽  
Ana Rodrigues Falbo ◽  
José Natal Figueiroa ◽  
Letícia Amorim Bezerra Barreto ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Patent Ductus Arteriosus ◽  
Very Low Birth Weight ◽  
Ductus Arteriosus ◽  
Preterm Neonates ◽  
Doppler Velocimetry ◽  
Portal Flow ◽  
Patent Ductus

scholarly journals Limited effects of intravenous paracetamol on patent ductus arteriosus in very low birth weight infants with contraindications for ibuprofen or after ibuprofen failure

2015 ◽  
Vol 174 (11) ◽  
pp. 1433-1440 ◽  
Author(s):  
Daniëlla W. E. Roofthooft ◽  
Ingrid M. van Beynum ◽  
Johan C. A. de Klerk ◽  
Monique van Dijk ◽  
John N. van den Anker ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Patent Ductus Arteriosus ◽  
Very Low Birth Weight ◽  
Ductus Arteriosus ◽  
Low Birth Weight Infants ◽  
Intravenous Paracetamol ◽  
Patent Ductus

scholarly journals Role of Sequential Functional Echocardiography in Predicting Clinically Apparent Patent Ductus Arteriosus in Preterm Very Low Birth Weight Newborns-An Observational Study

2021 ◽  
Author(s):  
Anchala Bhardwaj ◽  
Arvind Saili ◽  
Dinesh Kumar Yadav ◽  
Ajay Kumar
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Patent Ductus Arteriosus ◽  
Left Atrial ◽  
Very Low Birth Weight ◽  
Ductus Arteriosus ◽  
Preterm Neonates ◽  
Predictive Utility ◽  
Patent Ductus

Abstract Background-The management of patent ductus arteriosus in preterm neonates continues to be a topic of discussion and controversy. Prolonged ductal patency in preterm neonates has been associated with significant short and long-term morbidities and with increased mortality however, the policy of routine treatment of all during the neonatal period has failed to show significant improvement in the long-term outcome. Echocardiography has emerged as a promising modality to screen newborns at risk of adverse effects of ductal shunting. This helps in identifying PDAs that require treatment to ultimately prevent unnecessary therapy or delay of necessary therapy. There is a multitude of studies that have evaluated a large number of echocardiographic markers for their predictive utility but only a few have included all ductal markers together in a single study. The reported sensitivity (26-100%) and specificity (6-100%) of echocardiographic markers vary over a wide range. Thus, this study was planned to assess the predictive utility of all available ductal markers and their added advantage of having all over few ones in clinically apparent PDA in preterm VLBW newborns.Methods-It was an observational prospective study conducted in tertiary care NICU at Lady Hardinge Medical College, Delhi. Fifty preterms very low birth weight (VLBW) newborns underwent four sequential Echo scans within the first 72 hrs; the first scan within 12 hours, thereafter at 24 hrs,48 hrs, and 72 hrs of age and were monitored clinically for the signs of PDA up to two weeks of life or discharge whichever comes later.Results-The Ductal diameter, pulsatile ductal flow pattern, Left pulmonary artery (LPA) velocity, Left atrial to aortic width (La/Ao) ratio, Left atrial volume index (LAVI), Left ventricle to aortic width (Lv/Ao) ratio, E/A ratio and Left ventricular output/superior vena cava (LVO/SVC) flow ratio predicted clinically apparent PDA during first 72 hours of life.Conclusion- This study provides insights into the predictive utility of other ductal echo markers along with the routinely measured conventional ones during the first 72 hours of life in preterm VLBW newborns.

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