Closure of the patent ductus arteriosus with ibuprofen and other non-steroidal anti-inflammatory medications in neonates (original) (raw)
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International Journal of Pediatrics, 2020
Background The function of ductus arteriosus closes within a few minutes to a few days after birth in term neonates. In some cases, the duct remains open after birth, a condition which is called patent ductus arteriosus (PDA). PDA is associated with high rates of neonatal mortality and morbidity. The present study aims to evaluate the effect of oral ibuprofen on closure of PDA in term neonates. Materials and Methods In this clinical trial, 40 neonates (at the gestational age of 37 weeks and more) aged 5 to 30 days, with confirmed PDA through echocardiography, were randomly divided into two groups (n= 20). One group received ibuprofen syrup (10 mg/kg body weight) in the first 24 hours, followed by 5 mg/kg body weight for the next four days. The other group received placebo in the same manner. On the seventh day after the beginning of intervention, neonates underwent echocardiography for examination of PDA closure. Side effects of ibuprofen were evaluated. Symptoms of kidney failure, ...
Journal of Babol University of Medical Sciences, 2017
BACKGROUND AND OBJECTIVE: Patent ductus arteriosus (PDA) is a common problem in premature infants. Indomethacin is the first effective drug used to treat this problem and due to the side effects of this drug, intravenous ibuprofen is one of the recommended drugs in this field. Due to the unavailability of intravenous form of these drugs in Iran, this study was conducted to compare therapeutic effects and side effects of the oral form of ibuprofen and indomethacin on the closure of PDA in premature infants. METHODS: In this randomized clinical trial, 80 premature infants (less than 32 weeks) with symptomatic PDA, who required treatment were randomly divided into two groups of 40 and were treated with indomethacin or oral ibuprofen. Results (changes in PDA size and percentage of recovery) and complications (changes in creatinine and serum bilirubin, intraventricular hemorrhage, necrotizing enterocolitis and death) of treatment were recorded and compared between the two groups. (IRCT: 2015111024977N1) FINDINGS: There was no significant difference between the two groups in terms of confounding variables. The treatments had to be repeated for ten percent of patients (four patients) in both groups. PDA size did not change in ten percent of patients (four patients) in indomethacin group and did not change in seven point five percent of patients (three patients) in ibuprofen group. The two groups did not differ significantly in terms of probable side effects. None of the patients in the two groups needed surgery. CONCLUSION: Considering that in this study, the response rate and side effects of oral ibuprofen and indomethacin did not differ significantly, this drug could be an appropriate alternative for indomethacin when necessary.
Iranian Journal of Pediatrics, 2016
Background: The arterial ductus is a major communicative pathway which is naturally patent in the fetus, connecting the body of the major pulmonary artery to the descending aorta. Although usually closing on its own, the patent ductus arteriosus (PDA) may remain open in the second postnatal week due to a lack of prompt diagnosis in the initial days of life or an absence of prompt treatment. Objectives: To prevent the untoward sequelae of patency of the ductus arteriosus, and to avoid invasive surgery at higher ages, the researchers in the present study embarked on determining the effects of oral ibuprofen during the second postnatal week on newborns with patent ductus arteriosus. Patients and Methods: In this study, 70 neonates aged eight to 14 days, presenting at Khatam-al-Anbia clinic and the NICU ward of Shahid Sadoughi hospital in Yazd, Iran, who were diagnosed with PDA through auscultation of heart murmurs and echocardiography, were randomly assigned to two groups. The experimental group received oral ibuprofen of 10 mg/kg in day 1, 5 mg/kg in day 2, and 5 mg/kg in day 3 administered by their parents. The control group did not receive any drug. Parents were informed of the potential drug complications and side effects and asked to report them to the researchers if any occurred. Results: After intervention, the patent ductus arteriosus was closed in 62.9% of the neonates in the experimental group (35 newborns) who received oral ibuprofen, while it was closed in 54.3% of the control neonates (35 newborns) who did not receive any drug (P = 0.628). No complications were observed in either of the neonatal groups. Conclusions: Our findings showed that administration of oral ibuprofen had no significant effect on the medicinal closure of PDA in full-term neonates during the second postnatal week.
European Medical, Health and Pharmaceutical Journal, 2013
Patent ductus arteriosus (PDA) is common in very premature infants. Pharmacological closure of PDA with indomethacin, a prostaglandin inhibitor, has remained the mainstay of treatment in premature infants over the last three decades. Intravenous ibuprofen was recently shown to be as effective and to have fewer adverse reaction in preterm infants. If equally effective, then oral ibuprofen for PDA closure would have several important advantages over the intravenous route.
The Canadian journal of hospital pharmacy
There is no injectable ibuprofen product marketed to treat patent ductus arteriosus (PDA) in newborns in Canada. The authors' institution has used ibuprofen arginine in the past. In the absence of published evidence supporting use of this salt form of ibuprofen for neonatal PDA, a retrospective analysis was undertaken. To compare the effectiveness and adverse effects of ibuprofen arginine, ibuprofen tromethamine, and indomethacin in the treatment of PDA. This retrospective observational cohort study, for patients admitted between 2009 and 2015, included preterm infants with symptomatic PDA who received at least one dose of injectable indomethacin, ibuprofen tromethamine, or ibuprofen arginine. Three effectiveness end points were analyzed: closure after one course of treatment, repeat medical treatment, and surgical ligation. The secondary end points included acute kidney injury, necrotizing enterocolitis, chronic lung disease, and time to full enteral feeding. A total of 179 inf...
2015
Background: Patent ductus arteriosus (PDA) is a common problem encountered in premature infants, especially those with respiratory distress syndrome. PDA can lead to life-threatening complications. Intravenous ibuprofen was shown to be as effective and to cause fewer side effects. If ibuprofen is effective intravenously, it will probably be effective orally too. Aim: This study was designed to determine the effectiveness and safety of oral ibuprofen compared to IV ibuprofen or no intervention for closing a PDA in preterm infants with RDS. Material and methods: A prospective study, randomized, a blind fold was conducted in NICU, at UOGH "Koco Gliozheni", Tirana, from February 2010-August 2013. The study included a total of 128 preterm infants, 28-35weeks, ≤2500gr birth weight, in the first 48-96 hours of life, with SDR and confirm the presence of DBA's (Ǿ≥1.5mm) by echocardiografic examination. Infants were treated with Ibuprofen oral, intravenous Ibuprofen, no medical ...
European Journal of Pediatrics, 2002
Indomethacin (INDO) and, more recently, ibuprofen (IBU) have been used to treat haemodynamically significant patent ductus arteriosus (PDA) in preterm infants. Both are cyclo-oxygenase blockers, but seem to have a different influence on regional circulation. In a prospective, randomised, controlled study, we compared INDO and IBU with regard to efficacy and safety for the early non-invasive treatment of PDA. Doppler echocardiography was used to study 232 preterm infants (gestational age 23–34 weeks) with respiratory distress syndrome of whom 175 had persistent, haemodynamically significant PDA at 48–72 h of life. They were randomised to receive three intravenous doses of either INDO (0.2 mg/kg, at 12 h intervals) or IBU (a first 10 mg/kg dose followed by two doses of 5 mg/kg at 24 h intervals), recording rate of ductal closure, need for additional treatment, side-effects and clinical course. The efficacy of the pharmacological treatment was similar in the two groups (56/81, 69% INDO; 69/94, 73% IBU). Patients treated with INDO showed a significant increase in serum creatinine (89±24 versus 82±20 mmol/l, P=0.03) and a near-significant tendency for a lower fractional excretion of sodium (3±3 versus 4±2%, P=0.08); moreover, 12/81 (15%) INDO patients versus 1/94 (1%) IBU patients became oliguric (P=0.017). Conclusion: our findings confirm that, by comparison with indomethacin, ibuprofen has fewer effects on renal function in terms of urine output and fluid retention, with much the same efficacy and safety in closing patent ductus arteriosus in preterm infants with respiratory distress syndrome. In particular, no increased incidence of intracranial haemorrhage was observed after ibuprofen treatment.