口服美林对早产儿动脉导管未闭的疗效观察

目的　口服美林与消炎痛对早产儿动脉导管未闭 (PDA)的疗效和副作用进行对比分析 ,以便寻找更好的治疗方法。方法　将 35例早产儿PDA患儿随机分为 2组 :A组 17例给予口服美林治疗 ,B组 18例口服消炎痛治疗。结果　美林 16例PDA(94 1% )闭合 ,消炎痛组 10例 (6 1 1% )闭合 ,美林组PDA闭合率明显高于消炎痛组 (P <0 0 2 5 )。在副作用方面 ,美林组仅 1例 (5 9% )有少量胃出血 ,而消炎痛组 10例 (5 5 6 % )分别并发了坏死性小肠结肠炎 (2例 ) ,胃出血(2例 ) ,IVH 1例 ,肾功能损害 (4例 ) ,低血糖、低钠血症 (1例 ) ;明显高于美林组 (P <0 0 0 5 )。结论　口服美林治疗早产儿PDA不仅疗效优于消炎痛 ,而且副作用少 ,安全系数高     

早期口服布洛芬治疗极低出生体重儿动脉导管未闭的临床研究

目的：探讨早期口服布洛芬治疗极低出生体重儿（VLBWI）动脉导管未闭（PDA）的临床效果和安全性。方法：生后24 h内经床边心脏彩超确诊的有临床症状的VLBWI PDA 64例,随机分为治疗组和对照组,每组32例。治疗组生后24 h内口服布洛芬,首剂10 mg/kg,第2、3剂5 mg/kg,每剂间隔24 h。对照组给予安慰剂生理盐水1 mL/kg,第2、3剂0. 5 mL/kg,每剂间隔24 h。观察两组患儿的治疗效果及不良反应。结果：第1疗程结束后治疗组动脉导管关闭率为84%,明显高于对照组的41%,两组比较差异有统计学意义（P＜0.01）。治疗组脑室周围白质软化和支气管肺发育不良的发生率明显低于对照组（P＜0.05）;机械通气时间和平均住院时间明显短于对照组（P＜0.05）。两组脑室内出血、早期肺出血、坏死性小肠结肠炎的发生率等差异无统计学意义（P＞0.05）,且均未发现明显不良反应。结论：早期口服布洛芬治疗VLBWI PDA可以减少部分近期并发症的发生率,缩短住院时间,且未发现明显不良反应。     

心血管系统疾病

--051077口服美林对早产儿动脉导管未闭的疗效观察/龚长富…∥小儿急救医学.-204,11(5).-317～319将32例早产儿PDA患儿随机分为2组:A组17例给予口服美林治疗,B组18例口服消炎痛治疗。结果:美林16例PDA闭合,消炎痛组10例闭合,美林组PDA闭合率明显高于消炎痛组。口服美林治疗早产儿PDA不仅疗效优于消炎痛,而且副作用少,安全系数高。表2参10(张春妍)051078CTnI对先天性心脏病患儿围手术期心肌损伤的评估意义/李怀远…∥临床儿科杂志.-2004,22(10).-678～679051079经胸超声心动图在经心导管封堵小儿房间隔缺损中的应用/蒋国平…∥浙江大…     

长疗程消炎痛治疗早产儿动脉导管未闭疗效和血浆6-酮-前列腺素F_1α变化的研究

目的探讨长疗程和常规疗程（短疗程）消炎痛关闭早产儿动脉导管的疗效、安全性及治疗前后前列腺素水平的变化。方法设计前瞻性双盲随机对照试验。体重≥1250g的动脉导管未闭（PDA）早产儿随机分为短疗程组（对照组）[0.2mg/（kg.次）,确诊后即刻、12、36h各用1次]和长疗程组（试验组）[0.15mg/（kg.次）,确诊后即刻、12、36、48h各用1次]。在治疗前后监测血浆6-酮-前列腺素F1α水平,评估临床症状和心脏彩超改变,主要观察指标为动脉导管的关闭情况及不良反应。结果一个疗程消炎痛治疗后试验组动脉导管关闭率高于对照组（75.0%比64.3%,RR1.17,95%CI0.823～1.654）,少尿发生率低于对照组（7.1%比32.0%,RR0.22,95%CI0.053～0.938）。两组患儿血浆6-酮-前列腺素F1α在消炎痛治疗后较治疗前明显降低（280ng/L比295ng/L,P〈0.001）,但两组差异无统计学意义。结论长疗程消炎痛治疗早产儿PDA的疗效与短疗程相当,且降低了少尿的发生率,并未增加坏死性小肠结肠炎发生率。血浆6-酮-前列腺素F1α在应用消炎痛后降低。     

早产儿动脉导管未闭发病率及消炎痛治疗10年总结

目的探讨早产儿动脉导管未闭的发病率及消炎痛的治疗效果。方法根据早产儿及患动脉导管未闭例数计算早产儿动脉导管未闭的发病率。观察早产儿动脉导管未闭发病率与早产儿体重及胎龄的关系，探讨消炎痛对早产儿动脉导管未闭患儿的治疗效果。结果早产儿动脉导管未闭的发病率为５．０６％（６０／１１８５），出生体重≤１５００克者，其发病率为６．５４％（１０／１５５），～２０００克者为５．２５％（２７／５１４），～２５００克者为４．８８％（１９／３８９），≥２５００克者为３．１５％（４／１２７），各组发病率有显著性差异（ｘ２＝６４．８５，Ｐ＜０．０１）。早产儿动脉导管未闻发病率与胎龄无关（ｘ２＝０．３４４，Ｐ＞０．０５）。消炎痛治疗４１例，痊愈３１例（７５．８１％）。≤１５００克、２０００克、２５００克及≥２５００克等组消炎病治愈率分别１００％、９０．９１％、５３．８４％和０（ｘ２＝１３．６２，Ｐ＜０．０５），治愈率与胎龄无关。结论早产儿动脉导管未闻的发病率及消炎痛对其治愈率随出生体重增加而降低，两者与胎龄无关。     

早产儿动脉导管未闭的消炎痛治疗

目的 探讨消炎痛治疗早产儿动脉导管未闭(PDA)的疗效。方法 对确诊为早产儿PDA的20例患儿。以消炎痛每次0．1～0．3mg／kg鼻饲给药，每12小时一次。共用3次为一疗程。结果：第一个疗程PDA闭合为16例。第二个疗程PDA闭合1例．3例未闭合。结论 消炎痛关闭早产儿PDA成功率高，给药时间早,效果更佳。     

早产儿动脉导管未闭的消炎痛治疗

目的　 探讨消炎痛治疗早产儿动脉导管未闭 (PDA)的疗效。 方法 　对确诊为早产儿PDA的 2 0例患儿 ,以消炎痛每次 0 1～ 0 3mg/kg鼻饲给药 ,每 12小时一次 ,共用 3次为一疗程。结果 :第一个疗程PDA闭合为 16例 ,第二个疗程PDA闭合1例 ,3例未闭合。 结论 　消炎痛关闭早产儿PDA成功率高 ,给药时间早 ,效果更佳。     

消炎痛治疗足月新生儿动脉导管未闭疗效及安全性评价

目的 探讨口服消炎痛治疗足月新生儿动脉导管未闭(PDA)的疗效及安全性.方法 对经彩色多普勒超声心动图确诊的足月新生儿动脉导管未闭34例分为治疗组和对照组,治疗组23例给予服消炎痛治疗,每次0.2 mg/kg,鼻饲给药,每24小时1次,共用3次为一疗程,全部病例均仅用一疗程.未加用消炎痛治疗的11例作为对照组.比较两组动脉导管的关闭率;治疗组用药前后监测肾功能、血生化及血小板变化,观察记录尿量、胃肠道症状及出血情况等.结果 治疗组23例,动脉导管关闭17例,关闭率73.91%.对照组11例,关闭5例,关闭率45.45%,两组比较,治疗组PDA闭合率明显高于对照组,差异有显著性意义(P＜0.05).治疗组中除2例发生一过性少尿外,未发生其他不良反应.结论 消炎痛治疗足月新生儿PDA安全有效.     

早产儿动脉导管未闭临床治疗研究的循证医学证据

动脉导管未闭（PDA）是早产儿常见的先天性心脏病。与动脉导管已经闭合的早产儿相比,有PDA的早产儿更易发生严重的呼吸窘迫综合征、支气管肺发育不良、颅内出血等并发症,而且死亡的机率更高。1972年Kitterman首次应用外科治疗方法闭合动脉导管;1976年Heymann首次应用消炎痛治疗早产儿PDA。他们试图通过这些治疗手段来改善PDA患儿的预后。其后,有许多学者进行了早产儿PDA治疗方面的研究,他们都记录了用环氧合酶抑制剂（消炎痛、布洛芬、甲芬那酸等）或外科治疗方法进行早产儿PDA治疗的效果与安全性;与此同时,也有许多学者对这些治疗手段的效果和安全性进行比较和系统评价。现拟就关于早产儿有显著左向右分流的PDA使用不同治疗方法的比较研究介绍如下。     

胎膜早破对超早产儿早期预后的影响

目的 探讨胎膜早破（PROM）对超早产儿早期预后的影响,为超早产儿管理、产前咨询提供依据。方法 收集2017~2019年单胎超早产儿179例为研究对象,按是否存在PROM分为PROM组（69例）和非PROM组（110例）,对孕母情况及患儿早期预后指标进行统计分析。结果 PROM组早发型败血症和坏死性小肠结肠炎发生率高于非PROM组（P < 0.05）,肺表面活性物质使用率及血流动力学显著的动脉导管未闭发生率低于非PROM组（P < 0.05）。多因素logistic回归分析显示绒毛膜羊膜炎是早发型败血症、坏死性小肠结肠炎的独立危险因素（分别OR=11.062、9.437,P < 0.05）,PROM是使用肺表面活性物质的独立保护因素（OR=0.363,P < 0.05）。结论 PROM增加了超早产儿早发型败血症及坏死性小肠结肠炎的发生率,未增加其他不良结局发生率。对有超早产风险的PROM孕妇,建议积极保胎、预防绒毛膜羊膜炎以延长孕周、降低感染发生率,从而改善超早产儿结局。     

Comparison of ibuprofen and indomethacin therapy for patent ductus arteriosus in preterm infants

BACKGROUND: Patent ductus arteriosus (PDA) is commonly found in very low-birthweight (VLBW) infants. The presence of respiratory distress syndrome (RDS) is also associated with increased frequency of significant PDA. Intravenous indomethacin has been used to treat and to prevent PDA in premature infants since 1976. However, concern remains regarding the safety of indomethacin, which affects renal, gastrointestinal and cerebral perfusion. Intravenous ibuprofen has recently been used to treat and to prevent PDA premature infants with PDA without reducing cerebral blood flow or affecting intestinal or renal hemodynamics. The aim of the present study is to compare intravenous ibuprofen and indomethacin with regard to efficacy and safety for the early treatment of PDA in preterm infants. METHODS: A total of 63 preterm infants with RDS who had a birthweight of < or =1500 g and gestational age of < or =32 weeks, were enrolled in the present study. All patients were treated with nasal continuous positive airway pressure with additional oxygen supply in inspired air>30%, or with mechanical ventilation. The patients' serum platelet counts were>100,000/uL, and serum creatinine values were <1.5 mg/dL. There were no 3-4 grade intraventricular hemorrhages before randomization, and all patients were aged 2-7 days and had echo-cardio-graphic evidence of significant PDA. Patients were randomized into two groups: the first group of neonates (group A, n = 32) received intravenous ibuprofen lysine 10 mg/kg, followed by 5 mg/kg after 24 and 48 h; the second group (group B, n = 31) received intravenous indomethacin 0.2 mg/kg every 12 h for three doses. RESULTS: Patent ductus arteriosus closed in 27 patients from the ibuprofen group (84.4%) and in 25 patients from the indomethacin group (80.6%). PDA reopened in three patients from the ibuprofen group (9.4%) and in three patients from the indomethacin group (9.7%). One patient in the ibuprofen group and two patients in the indomethacin group required ductal ligation. Serum creatinine and blood urea nitrogen (BUN) concentrations were lower in the ibuprofen group than in the indomethacin group. Urine output and creatinine clearance values were higher in the ibuprofen group than in the indomethacin group. CONCLUSIONS: Ibuprofen therapy is as efficacious as indomethacin for the treatment of PDA in preterm infants. Infants treated with ibuprofen have higher creatinine clearance and urine output and lower serum creatinine and BUN values than infants treated with indomethacin.     

The Association between Patent Ductus Arteriosus and Perinatal Infection in A Group of Low Birth Weight Preterm Infants

Objective: Patent ductus arteriosus (PDA) is an extremely common occurrence in very premature infants. Untreated symptomatic PDA may be associated with chronic lung disease. PDA has a major role in neonatal mortality and morbidity. We compared the efficacy and safety of oral versus intravenous ibuprofen for the pharmacological closure of PDA in low birth weight (LBW) preterm infants. Methods: A randomized, single-blinded, controlled study was performed on premature neonates at the neonatal unit, University Hospital for Obstetrics and Gynecology “Koço Gliozheni”, Tirana, Albania from January 2010 to December 2012. The study enrolled 68 preterm infants with a confirmed and significant PDA. The preterm infants received either intravenous or oral ibuprofen randomly as an initial dose of 10 mg/kg, followed by 5 mg/kg at 24 and 48 h. Findings : 36 patients were treated with oral ibuprofen and 32 with intravenous ibuprofen during this period. After the first course of the treatment, the PDA closed in 30 (83.3%) of the patients assigned to the oral ibuprofen group versus 23 (71.8%) of those enrolled in the intravenous ibuprofen group (P=0.355). 15 patiens needed a second treatment course and they all (100%) had clinical signs of infection and positive blood culture. There was no reopening of the ductus after the closure. Conclusion: Our data indicate that, for LBW infants, the rate of early ductal closure was comparable and the adverse effects were fewer with oral ibuprofen in comparison to the intravenous route. Association of PDA with perinatal infection has a negative impact in pharmacological closure of the ductus, increasing the need for a second course of treatment or for surgery.Key Words: Prematurity, Perinatal Infection, Patent Ductus Arteriosus, Oral Ibuprofen, Intravenous Ibuprofen     

Prophylaxis of patent ductus arteriosus with ibuprofen in preterm infants

The aim of our study was to evaluate whether the prophylactic use of ibuprofen would reduce the incidence of significant patent ductus arteriosus (PDA) and to confirm the effectiveness of ibuprofen as rescue treatment in closing PDA. Eighty preterm infants with gestational age less than 34 wk with infant respiratory distress syndrome (iRDS) were randomized to receive intravenous ibuprofen lysine (10 mg/kg, followed by 5 mg/kg after 24 and 48 h) either within 24 h of life (group A) or after echocardiographic diagnosis of PDA (group B). To evaluate the severity of RDS in each patient, we calculated the initial and highest values of Oxygenation Index (O.I. = mean airway pressure x FiO2 x 100/PaO2) and Ventilatory Index (V.I. = O.I. x mechanical respiratory rate). Other studied variables were ventilatory support, renal function, biochemical and haematological profiles, frequency of bronchopulmonary dysplasia (BPD), intraventricular haemorrhage (IVH), necrotizing enterocolitis (NEC) and retinopathy of prematurity (ROP). On the 3rd day of life, 8% (3/40) of patients of group A and 53% of patients (21/40) of group B (p < 0.0001) developed a significant PDA. Between patients of group B who presented PDA at 3 d of life 90% (19/21) had a closure of ductus arteriosus after ibuprofen treatment. Initial and highest values of O.I. and V.I. were similar in both groups A and B. No significant differences between the groups were observed in regard to respiratory support, renal function and frequency of BPD, IVH, NEC and ROP. Ibuprofen was not associated with adverse effects. Conclusion: Prophylactic treatment with ibuprofen reduces PDA occurrence in preterm infants with iRDS at 3 d of life in comparison with rescue treatment, but both modes are effective in closing the ductus without significant adverse effects.     

Effects of indomethacin and ibuprofen on mesenteric and renal blood flow in preterm infants with patent ductus arteriosus

OBJECTIVE: To evaluate the effect of intravenous ibuprofen and indomethacin for treatment of patent ductus arteriosus (PDA) on mesenteric and renal blood flow velocity in preterm infants. STUDY DESIGN: Seventeen mechanically ventilated preterm infants (<33 weeks' gestation) with PDA received either 0.2 mg/kg indomethacin (n = 8) or 10 mg/kg ibuprofen (n = 9), infused over 15 minutes. Mesenteric and renal blood flow velocity were measured by using Doppler ultrasonography. RESULTS: Indomethacin caused a significant reduction in mesenteric and renal blood flow velocity 30 minutes after drug administration; mesenteric and renal blood flow velocity did not return to the pretreatment values by 120 minutes. Ibuprofen did not alter blood flow 30 minutes after treatment, and blood flow increased 120 minutes after treatment. Mesenteric and renal blood flow velocity changes were significantly different between the 2 treatment groups. CONCLUSIONS: Compared with indomethacin, ibuprofen did not significantly reduce mesenteric and renal blood flow velocity.     

Treatment of patent ductus arteriosus with ibuprofen

AIM—To evaluate the efficiency and side effects of ibuprofen for the early treatment of patent ductus arteriosus (PDA)and compare it with indomethacin.METHODS—Forty preterm infants with gestational ages of less than 33 weeks, with respiratory distress syndrome (RDS) and echocardiographically confirmed PDA, were randomly assigned at days 2 to 3 of life to receive either intravenous indomethacin 3 × 0.2 mg/kg at 12 hour intervals or intravenous ibuprofen 1 × 10 mg/kg, followed by 5 mg/kg 24 and 48 hours later.RESULTS—PDA closed in 15 of 20 patients from the indomethacin group (75%) and in 16 of 20 (80%) from the ibuprofen group. Seven patients (three indomethacin, four ibuprofen) required a second treatment with indomethacin and in five (three in the indomethacin group and two in the ibuprofen group) the duct was ultimately ligated. Ibuprofen patients had a better urinary output and showed no increase in serum creatinine concentrations compared with the indomethacin group. Ibuprofen was not associated with any other side effect.CONCLUSIONS—Ibuprofen treatment seems to be as efficient as indomethacin in closing PDA on the third day of life in preterm infants with respiratory distress syndrome and seems to have fewer renal side effects.     

Prophylactic ibuprofen therapy of patent ductus arteriosus in preterm infants

This study was aimed at evaluating the efficacy of ibuprofen in the prophylaxis of patent ductus arteriosus (PDA) in very preterm neonates and at detecting eventual side-effects. A total of 46 preterm neonates with gestational age under 31 weeks were randomly assigned at 2 h of life: 23 to the prophylaxis group and 23 to the control group. The prophylaxis group received intravenous treatment with ibuprofen lysine (10 mg/kg), followed by 5 mg/kg after 24 h and 48 h. No placebo was given to the control group. No PDA was demonstrated at 72 h of life in 20 of the 23 babies in the ibuprofen group (87%) nor in 7 of the 23 control neonates (30.4%). All neonates with PDA received treatment with indomethacin. One neonate in the prophylaxis group and three in the control group underwent surgical ligation. Prophylaxis with ibuprofen was not associated with any significant side-effect except for food intolerance. Conclusion Ibuprofen prophylaxis seems to be efficient in closing patent ductus arteriosus and in reducing indomethacin treatment. No significant early side-effects were found due to ibuprofen. Received: 1 April 1999 / Accepted: 30 November 1999     

Comparison of Oral Ibuprofen and Intravenous Indomethacin for the Treatment of Patent Ductus Arteriosus in Extremely Low Birth Weight Infants

ObjectiveThere are few published reports concerning the efficacy of oral ibuprofen for the treatment of patent ductus arteriosus (PDA) in extremely low birth weight (ELBW) infants. Oral ibuprofen was compared to intravenous indomethacin regarding efficacy and safety in the treatment of PDA in infants weighting less than 1,000 g at birth.MethodThis was a retrospective study in a single center. Data on ELBW infants who had an echocardiographically confirmed PDA were collected. The infants were treated with either intravenous indomethacin or oral ibuprofen. Rate of ductal closure, need for additional treatment, drug-related side effects or complications, and mortality were compared between the two treatment groups.Result26 infants who received indomethacin and 22 infants who received ibuprofen were studied. The overall rate of ductal closure was similar between the two treatments: it occurred in 23 of 26 infants (88.5%) treated with indomethacin, and in 18 of 22 infants (81.8%) treated with ibuprofen (p = 0.40). The rate of surgical ligation (11.5% versus 18.2%; p = 0.40) did not differ significantly between the two treatment groups. No significant difference was found in post-treatment serum creatinine concentrations between the two groups. There were no significant differences regarding additional side effects or complications.ConclusionIn ELBW infants, oral ibuprofen is as efficacious as intravenous indomethacin for the treatment of PDA. There were no differences between the two drugs with respect to safety. Oral ibuprofen could be used as an alternative agent for the treatment of PDA in ELBW infants.     

Comparison of Oral Ibuprofen with Oral Indomethacin for PDA Closure in Indian Preterm Neonates: A Randomized Controlled Trial

Oral ibuprofen is being used as an alternative to indomethacin in medical management of patent ductus arteriosus (PDA), but limited data exist on oral efficacy of these drugs for PDA closure in India. To assess and compare the efficacy of oral ibuprofen and oral indomethacin for PDA closure in preterm Indian neonates, we designed a randomized controlled study on clinically diagnosed and echocardiographically confirmed hemodynamically significant PDA in preterm neonates. Patients were assigned to receive either oral ibuprofen at a dosage of 10, 5, 5 mg/kg every 24 h or three doses of oral indomethacin (0.20–0.25 mg/kg every 24 h) starting on the third day of life or when diagnosed. A second course of ibuprofen/indomethacin was given, if PDA failed to close within 48 h after the first course. Patients were monitored for complications like oliguria, bleeding, necrotizing enterocolitis, intraventricular hemorrhage, oxygen dependency, and gastrointestinal side effects. The baseline characteristics were comparable in both groups. Of the 83 children enrolled, 57.8 % received oral ibuprofen and 42.1 % received oral indomethacin. The overall closure rate of PDA was 60 and 65.7 % in the ibuprofen and indomethacin groups, respectively. Closure rate was significantly higher when the drugs were administered at an early postnatal age (<8 days) (83.3 % [p = 0.02] in the indomethacin group and 75 % [p = 0.03] in the ibuprofen group) in neonates >28 weeks (ibuprofen group 66.7 % [p = 0.02]; indomethacin group 65.5 % [p = 0.04]) and in babies with birth weight >1,000 g (ibuprofen group 62.2 %; indomethacin group 70 % [p = 0.04 in both groups]). Complications were similar in both groups. The efficacy of both drugs was similar. Poor closure in our study could be because of genetic differences in pharmacokinetics of drug metabolism in the Indian population. Regimens with higher doses or increased duration of treatment may increase the frequency of closure. Studies with larger numbers of subjects with evaluation of pharmacokinetic parameters are therefore required.     

Safety and efficacy of ibuprofen versus indomethacin in preterm infants treated for patent ductus arteriosus: a randomised controlled trial

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 (< 1 ml/kg per h) during treatment (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.     

Total serum bilirubin levels during cyclooxygenase inhibitor treatment for patent ductus arteriosus in preterm infants

Aim: To determine whether ibuprofen use in VLBW infants is associated with increased serum bilirubin levels and impaired neurodevelopmental outcome at 2 years of age compared to indomethacin.
Methods: We retrospectively evaluated bilirubin data and outcome parameters of 178 VLBW infants treated with COX inhibitors for a haemodynamically relevant patent ductus arteriosus (PDA) between 1998 and 2003 in a single institution. In our department ibuprofen replaced indomethacin for PDA treatment in 2001, while clinical and echocardiagraphic criteria for the indication of PDA invention have remained unchanged.
Results: Ibuprofen and indomethacin therapy groups did not differ in their baseline clinical profile. Peak serum bilirubin concentration was 10.2 mg/dL in the ibuprofen group and 8.6 mg/dL in the indomethacin group (p < 0.01), while phototherapy duration did not differ. At 2 years of age neurodevelopmental outcome was similar in both groups. In a single case analysis, four cases of adverse neurodevelopmental outcome despite inconspicuous clinical course were identified in the ibuprofen group.
Conclusion: In VLBW infants with PDA, ibuprofen treatment was associated with higher bilirubin levels than indomethacin.