Surgical versus medical treatment with cyclooxygenase inhibitors for symptomatic patent ductus arteriosus in preterm infants

Malviya, Manoj N; Ohlsson, Arne; Shah, Sachin S

doi:10.1002/14651858.cd003951

Cited by 87 publications

(87 citation statements)

References 52 publications

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“…More is not better: early indomethacin is worse than later indomethacin 29 and ligation is worse than either medical therapy 29,34,35 or no treatment. 36 Pooled results from randomized-controlled trials These trials have been the subject of several Cochrane reviews, [113][114][115][116][117][118] which have found no evidence for long-term benefits of treatment to close the ductus. As the purpose of Cochrane reviews is identification of strong evidence in support of an intervention, many trials were excluded from meta-analyses because of methodological deficiencies.…”

Section: Findings From Individual Randomized-controlled Trialsmentioning

confidence: 99%

Treatment of persistent patent ductus arteriosus in preterm infants: time to accept the null hypothesis?

2010

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Section: Findings From Individual Randomized-controlled Trialsmentioning

confidence: 99%

Treatment of persistent patent ductus arteriosus in preterm infants: time to accept the null hypothesis?

2010

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“…Due to reduced renal side effects compared to other drugs, ibuprofen in three consecutive doses is administrated. Although current data are insufficient to support which primary therapeutic approach should be addressed first, surgical ligation or administration of inhibitors of cyclooxygenase, our preferred first approach is drug administration [17,18]. Subsequent haemodynamic changes with decreased blood flow in the aorta required the initiation of prostaglandin E1 therapy for the reopening of the ductus arteriosus, it being necessary until the time of corrective surgery.…”

Section: Discussionmentioning

confidence: 99%

Drug Closure of a Patent Ductus Arteriosus in An Extremely Low Birth Weight Premature Newborn. A Case Report

Moldovan

Cucerea

2015

The Journal of Critical Care Medicine

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Introduction: Patent ductus arteriosus involves maintaining the permeability of the vascular ductus located between the pulmonary artery and the descending aorta, due to the failure of transition from foetal to adult type circulation. This malformation is characteristic to premature newborns with extremely low birth weight. The main pathophysiological factors identified in this pathology are immaturity of the smooth muscles, presence of vasodilator mediators and persistent hypoxaemia. Ductal-dependent cardiac malformations require drug therapy for keeping the permeability of the ductus arteriosus until the time of corrective surgery. Case presentation: We present the case of an extremely low birth weight premature newborn, derived from twin pregnancy with suspected specific pathology, respectively feto-fetal transfusion syndrome, admitted to the Regional Centre of Neonatal Intensive Care Unit Tîrgu-Mureş.

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“…In the last decade, similar results have been observed with the use of ibuprofen IV; both drugs have been shown to be equally effective in ductal closure and to reduce surgical ligation rates of PAD [13][14][15] . If closure of the PAD is not achieved with one or two cycles of NSAID therapy, surgical closure is indicated 16 . More recently, paracetamol has been used, however clinical experience is still under development 17,18 .…”

Section: Introductionmentioning

confidence: 99%

Complicaciones digestivas y renales por indometacina e ibuprofeno en prematuros extremos con ductus arterioso permeable

Salas

Lavín

Rincón³

et al. 2017

Rev. chil. pediatr.

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The symptomatic patent ductus arteriosus (sPDA) is common in extremely premature infants (EPI). In order to decrease the hemodynamic repercussion and avoid complications it is necessary to close it. Indomethacin or ibuprofen are used for this purpose with its associated risks. Objective: Characterize digestive and renal complications in EPI who received indomethacin or ibuprofen as sPDA treatment. Patients and Method: Retrospective study on EPI between January-2004 and December-2013. Three groups were compared: treated with indomethacin or ibuprofen and a non-treated group. EPI with other serious complications were excluded. The primary outcomes on each group were digestive and/or renal complications. Statistical significance was p < 0.05. Results: 599 EPI were included, 33.1% with PDA received treatment and 66.9% did not need it. A statistical association was found between sPDA and lower gestational ages, neonatal depression and respiratory distress. In the non-treated group, 5% presented enterocolitis and 0.25% renal failure; on the treated group, 2.5% presented enterocolitis and 1.0% renal failure. No significant differences were found between the treated and non-treated groups in relation to complications considering enterocolitis (p = 0.11) or renal failure (p = 0.33) alone, or combined (p = 0.17). No difference were detected either between those treated with indomethacin or ibuprofen. Conclusions: The results show that in absence of other clinical complication, medical treatment of sPDA with indomethacin or ibuprofen, do not increase the risk of serious digestive or renal disorders. There were no advantages of using indomethacin or ibuprofen over the other.original arTicle 244Premature infants with patent ductus arteriosus and aine -r. Salas et al

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Surgical versus medical treatment with cyclooxygenase inhibitors for symptomatic patent ductus arteriosus in preterm infants

Abstract: The data regarding net benefit/harm are insufficient to make a conclusion as to whether surgical ligation or medical treatment with indomethacin is preferred as initial treatment for symptomatic PDA in preterm infants.

Cited by 87 publications

References 52 publications

Treatment of persistent patent ductus arteriosus in preterm infants: time to accept the null hypothesis?

Treatment of persistent patent ductus arteriosus in preterm infants: time to accept the null hypothesis?

Drug Closure of a Patent Ductus Arteriosus in An Extremely Low Birth Weight Premature Newborn. A Case Report

Complicaciones digestivas y renales por indometacina e ibuprofeno en prematuros extremos con ductus arterioso permeable

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