Paracetamol for the treatment of patent ductus arteriosus in preterm neonates: a systematic review and meta-analysis

Abstract

Efficacy and safety of paracetamol appear to be comparable with those of ibuprofen. These results should be interpreted with caution, taking into account the non-optimal quality of the studies analysed and the limited number of neonates treated with paracetamol so far.

Acetaminophen for Patent Ductus Arteriosus in Extremely Low-Birth-Weight Neonates

“…The use of acetaminophen to facilitate ductal closure in this population is supported by numerous observational studies. 9,[17][18][19][20][21][22] Similarly to the randomized controlled trials, most neonates in these reports were more mature than our study population and most acetaminophen courses were initiated within the first week of life. Notable exceptions include recent reports of acetaminophen use in extremely premature neonates treated at a late postnatal age.…”

“…4 Four small randomized controlled studies have found no significant difference in safety or efficacy between oral acetaminophen and NSAIDs for the treatment of PDA in premature neonates, and multiple observational studies have analyzed the efficacy of acetaminophen. [5][6][7][8][9] Based on the available data, our institutional guidelines changed in late 2014 to include acetaminophen as a possible primary treatment for PDA for neonates with contraindications to NSAID treatment as well as an alternative to surgical ligation for neonates who have failed therapy with indomethacin. Acetaminophen therapy is not without risk.…”

Paracetamol (acetaminofeno) intravenoso para cierre de conducto arterioso permeable en prematuros ≤ 32 semanas de gestación

“…El sexo más afectado en nuestra serie fue el femenino, con una relación 2.5:1, tendencia ya previamente reportada en otras revisiones 14 . Utilizamos la misma dosis sugerida por otros autores 13 , de 15 mg/kg cada 6 horas, con una duración de 3 días, pero fue necesario extender la duración del tratamiento hasta 6 días por escasa respuesta en las primeras 72 horas (solo el 24% de los pacientes habían cerrado con 3 días de tratamiento).…”

“…Tanto la indometacina como el ibuprofeno promueven el cierre ductal en el 70-80% de los casos 11 . Recientemente se ha demostrado que el paracetamol es tan efectivo como el ibuprofeno para el cierre del PCA en prematuros 12,13 . La dosis de paracetamol utilizada para el cierre del PCA es de 15 mg/kg cada 6 horas durante 3 a 7 días 13 .…”

Effect of bronchopulmonary dysplasia on early intellectual development in preterm infants

“…Persistent pulmonary hypertension of the newborn was diagnosed using echocardiogram parameters and by assessing the difference between preductal and post‐ductal saturations . Patent ductus arteriosus (PDA) was defined according to echocardiography . A diagnosis of shock was based on clinical, hemodynamic, and biochemical signs …”