ORIGINAL ARTICLE: Comparison of Two Neonatal Indomethacin Protocols: Efficacy and Outcome for Patent Ductus Arteriosus Closure

Rosito, Guido Bernardo Aranha; Sum, Katie; Chorne, Nancy

doi:10.1111/j.1365-2710.2009.01142.x

Cited by 3 publications

(1 citation statement)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a retrospective study, Rosito et al [80] compared indomethacin infusions over a 4-hour period every 24 hours with a new regimen where indomethacin was now infused over 30 minutes at a 12-hour dosing interval. Although there was a trend towards a higher rate of PDA closure and a lower need for surgical ligation of the ductus with the 12-hour dosing regimen, the differences did not reach statistical significance.…”

Section: Management Of Neonatal Pdamentioning

confidence: 99%

Patent Ductus Arteriosus in Premature Neonates

Mezu‐Ndubuisi

Agarwal

Raghavan

et al. 2012

Drugs

View full text Add to dashboard Cite

Persistent patency of the ductus arteriosus is a major cause of morbidity and mortality in premature infants. In infants born prior to 28 weeks of gestation, a hemodynamically-significant patent ductus arteriosus (PDA) can cause cardiovascular instability, exacerbate respiratory distress syndrome, prolong the need for assisted ventilation, and increase the risk of bronchopulmonary dysplasia, intraventricular hemorrhage, renal dysfunction, intraventricular hemorrhage, cerebral palsy, and mortality. In this article, we review the pathophysiology, clinical features, and assessment of hemodynamic significance, and provide a rigorous appraisal of the quality of evidence to support current medical and surgical management of PDA of prematurity. Cyclo-oxygenase inhibitors such as indomethacin and ibuprofen remain the mainstay of medical therapy for PDA, and can be used both for prophylaxis as well as rescue therapy to achieve PDA closure. Surgical ligation is also effective and is used in infants who do not respond to medical management. Although both medical and surgical treatment have proven efficacy in closing the ductus, both modalities are associated with significant adverse effects. Because the ductus does undergo spontaneous closure in some premature infants, improved and early identification of infants most likely to develop a symptomatic PDA could help in directing treatment to the at-risk infants and allow others to receive expectant management.

show abstract

Section: Management Of Neonatal Pdamentioning

confidence: 99%

Patent Ductus Arteriosus in Premature Neonates

Mezu‐Ndubuisi

Agarwal

Raghavan

et al. 2012

Drugs

View full text Add to dashboard Cite

show abstract

An advanced ultrasound-activated drug delivery system with piezocatalytic MoS2 nanoflowers for treating patent ductus arteriosus

Ganguly,

Wang,

Lin

et al. 2024

Applied Materials Today

View full text Add to dashboard Cite

Efficacy and safety of pharmacological treatments for patent ductus arteriosus closure: A systematic review and network meta-analysis of clinical trials and observational studies

Marconi

Bettiol

Ambrosio

et al. 2019

Pharmacological Research

View full text Add to dashboard Cite

Efficacy and safety profiles of different pharmacological interventions used to treat patent ductus arteriosus (PDA) are relatively unexplored. Integrating the findings of randomized clinical trials (RCTs) with those from observational studies may provide key evidence on this important issue.We aimed at estimating the relative likelihood of failure to close the PDA, need for surgical closure, and occurrence of adverse events among preterm and full-term infants treated with indomethacin, ibuprofen, or acetaminophen, placebo, or no treatment including both RCTs and observational studies.We searched PubMed, Embase, and the Register of Controlled Trials from inception to October 30, 2018. We first estimated proportions of subjects with failure to close the PDA, subjects in whom surgical closure was performed after pharmacological treatment, death, and subjects with selected adverse events (AEs). These estimates were obtained using frequentist random-effect meta-analysis of arm-specific proportions. We then compared active drugs with each other and with control (either placebo or no treatment) by summarizing results at the end of treatment reported in the papers, regardless of number of administration(s), dose, route and type of administration, and study design and quality. We also summarized primary outcome results separately at first, second and third cycles of treatment. These estimates were obtained using Bayesian random-effects network meta-analysis for mixed comparisons, and frequentist random-effect pairwise meta-analysis for direct comparisons.We included 64 RCTs and 24 observational studies including 14,568 subjects (5339 in RCTs and 9229 in observational studies, 8292 subjects received indomethacin, 4761 ibuprofen, 574 acetaminophen, and 941 control (including placebo or no intervention).The proportion of subjects with failure to close the PDA was 0.24 (95% Confidence Interval, CI: 0.20, 0.29) for indomethacin, 0.18 (0.14, 0.22) for ibuprofen, 0.19 (0.09, 0.30) for acetaminophen, and 0.59 (0.48, 0.69) for control . At end of treatment, compared to control, we found inverse associations between all active drugs and failure to close PDA (for indomethacin Odds Ratio, OR, was 0.17 [95% Credible Interval,

show abstract

ORIGINAL ARTICLE: Comparison of Two Neonatal Indomethacin Protocols: Efficacy and Outcome for Patent Ductus Arteriosus Closure

Cited by 3 publications

References 4 publications

Patent Ductus Arteriosus in Premature Neonates

Patent Ductus Arteriosus in Premature Neonates

An advanced ultrasound-activated drug delivery system with piezocatalytic MoS2 nanoflowers for treating patent ductus arteriosus

Efficacy and safety of pharmacological treatments for patent ductus arteriosus closure: A systematic review and network meta-analysis of clinical trials and observational studies

Contact Info

Product

Resources

About