Oral versus intravenous ibuprofen for patent ductus arteriosus closure: a randomised controlled trial in extremely low birthweight infants

Erdeve, Ömer; Yurttutan, Sadık; Altuğ, Nahide; Оздемир, Рамазан; Gökmen, Tülin; Dilmen, Uğur; Oğuz, Şerife Suna; Uraş, Nurdan

doi:10.1136/archdischild-2011-300532

Cited by 87 publications

(81 citation statements)

References 29 publications

(50 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Oral, but not IV, ibuprofen was associated with rise in cystatin-C levels, a marker of impaired renal function, in preterm infants indicating that infants with borderline renal function may need careful monitoring [144]. Erdeve et al [145] performed an RCT of oral versus IV ibuprofen in 80 preterm infants and found a higher initial closure rate and reduction in the incidence of BPD with oral ibuprofen though there was a higher reopening rate in infants who received this treatment. A meta-analysis that included two studies ( n = 166) comparing oral ibuprofen with IV ibuprofen showed higher PDA closure rate with oral ibuprofen in comparison with IV ibuprofen and did not show a significant difference in adverse effects [146].…”

Section: How To Treat?mentioning

confidence: 99%

Patent Ductus Arteriosus in Preterm Infants: Do We Have the Right Answers?

Abdel‐Hady

Nasef

Shabaan

et al. 2013

BioMed Research International

View full text Add to dashboard Cite

Patent ductus arteriosus (PDA) is a common clinical condition in preterm infants. Preterm newborns with PDA are at greater risk for several morbidities, including higher rates of bronchopulmonary dysplasia (BPD), decreased perfusion of vital organs, and mortality. Therefore, cyclooxygenase (COX) inhibitors and surgical interventions for ligation of PDA are widely used. However, these interventions were reported to be associated with side effects. In the absence of clear restricted rules for application of these interventions, different strategies are adopted by neonatologists. Three different approaches have been investigated including prophylactic treatment shortly after birth irrespective of the state of PDA, presymptomatic treatment using echocardiography at variable postnatal ages to select infants for treatment prior to the duct becoming clinically significant, and symptomatic treatment once PDA becomes clinically apparent or hemodynamically significant. Future appropriately designed randomized controlled trials (RCTs) to refine selection of patients for medical and surgical treatments should be conducted. Waiting for new evidence, it seems wise to employ available clinical and echocardiographic parameters of a hemodynamically significant (HS) PDA to select patients who are candidates for medical treatment. Surgical ligation of PDA could be used as a back-up tool for those patients who failed medical treatment and continued to have hemodynamic compromise.

show abstract

Section: How To Treat?mentioning

confidence: 99%

Patent Ductus Arteriosus in Preterm Infants: Do We Have the Right Answers?

Abdel‐Hady

Nasef

Shabaan

et al. 2013

BioMed Research International

View full text Add to dashboard Cite

show abstract

“…In contrast to high closure rates, several adverse effects have been reported with such medications, including gastrointestinal bleeding and perforation, weakened platelet aggregation, hyperbilirubinaemia and renal failure 1 2. The role of paracetamol as an alternative treatment for the closure of hsPDA has gained importance in recent years due to these potential side effects 3…”

mentioning

confidence: 99%

An alternative drug (paracetamol) in the management of patent ductus arteriosus in ibuprofen-resistant or contraindicated preterm infants

Öncel

Yurttutan

Uraş

et al. 2012

Arch Dis Child Fetal Neonatal Ed

Self Cite

View full text Add to dashboard Cite

Introduction Haemodynamic changes occurring during the fetal -neonatal transition may impact on global myocardial function in the first week of life. Tissue Doppler imaging (TDI) offers a novel technique to measure changes in systolic and diastolic function in neonates. Aims To use TDI to assess myocardial function in preterm infants compared to gold standard measures. Methods Preterm infants < 32 weeks gestation were recruited. Echocardiography was carried out by a single observer (KA) using the GE Vivid I, on Day 1, 3-4 and Day 7. Clinical parameters were recorded at time of echocardiogram. Standard M mode echocardiography was used to determine shortening and ejection fraction. Myocardial velocities were obtained using a pulsed wave doppler sample from the lateral mitral/tricuspid annuli and intraventricular septum from an apical four chamber view. Peak systolic (S'), early diastolic (E') and late diastolic (A') velocities were recorded. Results 140 echocardiograms were performed on 60 neonates with structurally normal hearts. Gestational age range-23 +6 -31

show abstract

“…The most commonly used drugs for this purpose are cyclooxygenase inhibitors, mainly indomethacin and ibuprofen, which block the conversion of arachidonic acid to prostaglandins [1,2]. The reported treatment success with ibuprofen for the management of hsPDA is between 70 and 85% [3,4,5,6]. On the other hand, several adverse effects have been reported with such medications, including peripheral vasoconstriction, gastrointestinal bleeding and perforation, weakened platelet aggregation, hyperbilirubinemia and renal failure [7,8].…”

Section: Introductionmentioning

confidence: 99%

Intravenous Paracetamol Treatment in the Management of Patent Ductus Arteriosus in Extremely Low Birth Weight Infants

Öncel¹,

Yurttutan²,

Değirmencioğlu³

et al. 2012

Neonatology

Self Cite

112

View full text Add to dashboard Cite

Background: Treatment options for the closure of a hemodynamically significant patent ductus arteriosus (hsPDA) include medical therapy such as ibuprofen and indomethacin and surgical ligation. Objective: To evaluate the efficacy of intravenous paracetamol in preterm infants with hsPDA whose feeding was contraindicated or had feeding intolerance. Methods: Preterm infants with hsPDA were started on intravenous paracetamol treatment with parental consent. Paracetamol was administered at a dose of 60 mg/kg/day, in four divided doses, for a period of 3 days. In the absence of closure of hsPDA, treatment was extended up to 6 days, after which echocardiographic examination was performed. Results: A total of 10 preterm infants were included in the study with a median gestational age of 27^4/7 weeks (minimum–maximum: 24–29) and a median birth weight of 775 g (590–990). The first dose of intravenous paracetamol was given after a median of 6 days (2–15). On echocardiographic examination, median internal ductal diameter was 2 mm (1.5–3), with a median left atrium-to-aortic root ratio of 1.95 (1.6–2.2). Intravenous paracetamol resulted in successful closure of hsPDA in all patients. Conclusions: This study is the first case series in the literature which used intravenous paracetamol treatment for hsPDA. We believe that intravenous paracetamol could be used as an alternative drug for infants. Further prospective randomized-controlled trials are needed to evaluate the efficacy of intravenous paracetamol for the closure of hsPDA.

show abstract

Oral versus intravenous ibuprofen for patent ductus arteriosus closure: a randomised controlled trial in extremely low birthweight infants

Abstract: Oral ibuprofen is as effective as intravenous ibuprofen for PDA closure even in ELBW infants.

Cited by 87 publications

References 29 publications

Patent Ductus Arteriosus in Preterm Infants: Do We Have the Right Answers?

Patent Ductus Arteriosus in Preterm Infants: Do We Have the Right Answers?

An alternative drug (paracetamol) in the management of patent ductus arteriosus in ibuprofen-resistant or contraindicated preterm infants

Intravenous Paracetamol Treatment in the Management of Patent Ductus Arteriosus in Extremely Low Birth Weight Infants

Contact Info

Product

Resources

About