布洛芬治疗早产儿动脉导管未闭失败的影响因素分析

目的：探究布洛芬治疗胎龄小于37周且出生体质量<1 500 g早产儿动脉导管未闭（PDA）失败的影响因素,寻找PDA布洛芬治疗失败的危险因素。方法：选取2017年1月30日至2019年3月30日于我院就诊的400例胎龄<37周且出生体质量<1 500 g的PDA早产儿,均接受布洛芬治疗和床旁心电图检查。根据动脉导管是否封闭分为动脉导管未封闭组和动脉导管封闭组,分析早产儿PDA治疗失败的影响因素。结果：400例PDA患儿在接受布洛芬治疗后,140例导管未封闭,治疗失败率为35.0%,导管封闭260例,封闭率为65.0%。动脉导管未封闭组胎龄小于动脉导管封闭组,出生体质量低于动脉导管封闭组,动脉导管两端压差、宫内窘迫、窒息史、合并感染、呼吸支持、新生儿临床危险指数评分、左心房与主动脉根部内径比高于动脉导管封闭组,首次治疗日龄大于动脉导管封闭组,差异有统计学意义（P<0.05）。多因素回归分析结果显示,出生体质量、呼吸窘迫综合征、新生儿临床危险指数评分、窒息史、动脉导管两端压差、呼吸支持、合并感染是布洛芬治疗PDA失败的独立影响因素。结论：出生体质量低、合并宫内窘迫、呼吸窘迫综合征、感染、动脉导管两端压差较大、呼吸支持、新生儿临床危险指数评分>5分是出生体质量小于1 500 g PDA早产儿布洛芬治疗失败的危险因素。     

布洛芬治疗早产儿动脉导管未闭疗效及随访观察

目的观察口服布洛芬治疗早产儿动脉导管未闭（PDA）的疗效及安全性。方法发生症状性PDA的早产儿25例,出生体重（1490.16±329.76）g,胎龄（31.16±1.88）周。用口服布洛芬混悬滴剂治疗,首剂10mg.kg-1,于24、48h分别再给5mg.kg-1。用药期间观察患儿尿量、黄疸、有无消化道出血等情况,用药前及疗程结束后均检测血尿素氮、肌酐、胆红素、电解质、血小板和心脏超声心动图。结果 PDA关闭16例,关闭率为64%,其中未闭孔径〈2mm 7例（7/7）,2～3mm 5例（8/14）,〉3mm 1例（1/4）。关闭率与未闭孔径大小明显相关,孔径越大效果越差。单纯性PDA 17例,关闭13例,关闭率为76.4%。〈1500g关闭率72.7%（8/11）,〉1500g关闭率为83.3%（5/6）,两者比较无显著性差异（P〉0.05）。大PDA中有两例未闭但导管较前缩小。复合性8例关闭3例,关闭率为37.5%。所有关闭病例经10个月至4年的随访（心脏B超检查）,均未见复发。结论口服布洛芬不仅安全、有效,且使用方便,但仍需进行早产儿药代动力学研究。     

口服布洛芬治疗有症状性早产儿动脉导管未闭临床观察

目的：观察口服布洛芬治疗有症状性早产儿动脉导管未闭（PDA）的疗效及安全性。方法：发生症状性PDA的早产儿78例,用口服布洛芬混悬滴剂治疗,布洛芬10mg/kg,共3次,间隔24h。第一疗程结束后复查心脏彩色多普勒,如未关闭,使用第二疗程。用药前检查肾功能、血常规、超声心动图,治疗结束后复查肾功能、血常规、超声心动图。结果：本组早产儿经布洛芬1个疗程治疗,PDA的关闭率为67.94%,经过2个疗程治疗后,最终关闭PDA的总有效率为78.21%。疗效与出生体质量、胎龄有关,出生体质量≥1500g组疗效好于出生体质量〈1500g组（P〈0.05）;胎龄31～34周组疗效好于胎龄28～30周组（P〈0.05）。78例中5例（6.41%）出现喂养不耐受,经减少喂养量或暂停喂养后好转,未观察到其他不良反应。结论：口服布洛芬治疗早产儿PDA疗效好且安全,值得在基层医院大力推广。     

预防性口服布洛芬对早产儿动脉导管未闭的临床价值

目的 评价预防性口服布洛芬治疗早产儿动脉导管未闭(PDA)的疗效与安全性。 方法 选取西安高新医院新生儿科2013年3月至2016年3月收治的153例胎龄小于30周的早产儿作为研究对象,采用随机数字表法分为预防性治疗组76例和常规治疗组77例。预防性治疗组,出生后24 h内给予口服首剂布洛芬10 mg·kg-1,每隔24 h后口服第二、三剂布洛芬5 mg·kg-1。常规治疗组在出生后第3天对超声证实存在PDA的患儿给予相同剂量的布洛芬口服。出生后第3天,第7天分别行心脏超声检查,抽外周血查肾功及血常规,并监测有无不良反应,两组进行观察比较。 结果 预防性治疗组在出生后第3天及出生后第7天PDA关闭率(73.7%、78.9%)均高于常规治疗组(55.8%、63.2%),差异有统计学意义(P<0.05);预防性治疗组在出生后第3天及出生后第7天的尿素氮及肌酐水平与常规治疗组相比,差异无统计学意义(P>0.05);在近期并发症如肾功损害、尿少、坏死性小肠结肠炎、重度脑室内出血发生率方面两组差异无统计学意义(P>0.05)。 结论 口服布洛芬能够有效关闭早产儿动脉导管,不增加近期不良反应发生率,安全性好。     

布洛芬治疗150例早产儿动脉导管未闭的临床分析

目的 探讨布洛芬制剂治疗新生儿动脉导管未闭(PDA)的疗效及安全性。方法 早产儿动脉导管未闭150例,根据有无其他心脏畸形,分为单纯动脉导管未闭组和复杂动脉导管未闭组,根据出生体重分为≥1500 g组及<1500 g组。均给以布洛芬口服治疗,观察其疗效及不良反应。结果 单纯动脉导管未闭组≥1500 g组闭合率96%,<1500 g组闭合率为89.3%,其总闭合率92.5%;复杂动脉导管未闭组≥1500 g组闭合率46.6%,<1500 g组闭合率为42.9%,其总闭合率44.2%。单纯动脉导管未闭组与复杂动脉导管未闭组比较差异有统计学意义(χ2=42.7,P<0.01),而单纯动脉导管未闭组/复杂动脉导管未闭组在出生体重分组上差异无统计学意义(χ2=2.68,P>0.05)。所有参与治疗的患者中1例出现胃潴留,4例出现尿量减少,未观察到其他不良反应。结论 布洛芬口服治疗早产儿单纯性PDA疗效好,对复杂性PDA也有一定疗效。     

动脉导管未闭早产儿口服布洛芬治疗中超声心动图监测的价值

目的 探讨动脉导管未闭(PDA)早产儿口服布洛芬治疗中超声心动图监测的价值.方法 将生后7d内经超声心动图确诊的PDA早产儿(PDA直径小于5mm) 142例随机分为两组:观察组82例,口服布洛芬治疗;对照组60例,未服用布洛芬.超声心动图监测动脉导管关闭率.结果 观察组PDA直径＜3m者,闭合率90.3％,明显高于对照组的67.5％ (P＜0.05).观察组PDA直径为3-5 mm者,治疗后闭合率30.0％,明显高于对照组的15.0％ (P＜0.05).结论 超声心动图监测有助于评估PDA早产儿口服布洛芬疗效,并可根据PDA直径大小指导临床治疗.     

口服布洛芬治疗早产儿动脉导管未闭的疗效及安全性分析

目的:探究布洛芬治疗早产儿动脉导管未闭的疗效以及安全性.方法:在2016年1月～2017年5月收治的动脉导管未闭早产儿中选出128例随机分组,对照组给予吲哚美辛口服,观察组给予布洛芬口服,对比两组关闭率、不良反应发生率、生化检验等.结果:观察组治疗1个疗程的动脉导管关闭率60.94％略高于对照组的51.56％(P>0.05);观察组不良反应发生率4.69％明显低于对照组的17.19％,P<0.05;两组住院时间差异无统计学意义(P>0.05);观察组治疗1个疗程时的血小板计数、血浆PGE2、血清NT-probe均低于对照组,P<0.01.结论:布洛芬口服有助于促进早产儿动脉导管的关闭,安全性较好,值得推广.     

早产儿动脉导管未闭的护理

目的探讨早产儿动脉导管未闭(PDA)的护理措施。方法对38例PDA患儿进行观察和护理。结果 38例患儿临床症状消失,其中22例心脏彩超提示动脉导管关闭,16例管径较前减小。结论早产儿PDA病情危重,并发症多,通过布洛芬的应用,密切监测,精心护理,可早期安全关闭DA。主要护理措施为病情监测,输液管理,安全应用布洛芬,呼吸支持。     

布洛芬治疗早产儿动脉导管未闭42例临床研究

目的 研究布洛芬治疗早产儿动脉导管未闭(PDA)的临床疗效,分析布洛芬的不良反应。方法 本院新生儿科重症监护室的42例胎龄<35周,体重<2000 g合并动脉导管未闭的早产儿,布洛芬治疗3 d,监测用药前及用药期间(第3天)肾功能、电解质、凝血功能、血常规;用药疗程结束后复查心脏彩超,并分析应用布洛芬出现的不良反应。结果 经布洛芬鼻饲或口服治疗3 d,28例(66.7%)动脉导管关闭,其中10例(23.8%)动脉导管关闭后再次开放。25例(59.5%)出现少尿,28例(66.7%)出现喂养不耐受,25例(59.5%)出现消化道出血。用药前及用药期间(第3天)观察指标,尿量比较,差异有统计学意义(P<0.05);肌酐、血小板、凝血功能、电解质比较差异均无统计学意义(P>0.05)。结论 布洛芬治疗早产儿动脉导管未闭临床疗效显著,但再次开放的可能性存在。不良反应主要表现为少尿、喂养不耐受、消化道出血等,但大多数不良反应经停药或对症处理后均能明显好转,安全性较高。     

布洛芬治疗早产儿动脉导管未闭42例临床研究

目的 研究布洛芬治疗早产儿动脉导管未闭(PDA)的临床疗效,分析布洛芬的不良反应。方法 本院新生儿科重症监护室的42例胎龄<35周,体重<2000 g合并动脉导管未闭的早产儿,布洛芬治疗3 d,监测用药前及用药期间(第3天)肾功能、电解质、凝血功能、血常规;用药疗程结束后复查心脏彩超,并分析应用布洛芬出现的不良反应。结果 经布洛芬鼻饲或口服治疗3 d,28例(66.7%)动脉导管关闭,其中10例(23.8%)动脉导管关闭后再次开放。25例(59.5%)出现少尿,28例(66.7%)出现喂养不耐受,25例(59.5%)出现消化道出血。用药前及用药期间(第3天)观察指标,尿量比较,差异有统计学意义(P<0.05);肌酐、血小板、凝血功能、电解质比较差异均无统计学意义(P>0.05)。结论 布洛芬治疗早产儿动脉导管未闭临床疗效显著,但再次开放的可能性存在。不良反应主要表现为少尿、喂养不耐受、消化道出血等,但大多数不良反应经停药或对症处理后均能明显好转,安全性较高。     

Ibubrofen in the treatment of patent ductus arteriosus in preterm infants: what we know, what we still do not know

The patency of the ductus arteriosus has ever been considered as a pathological situation in preterm infants and one likely cause of mortality and morbidity, including broncho-pulmonary dysplasia, necrotizing enterocolitis, intraventricular haemorrhage, retinopathy of prematurity. The incidence of patent ductus arteriosus is inversely proportional to gestational age and infants with the lowest gestational ages are the most exposed to the complications of prematurity. So, associations between patent ductus arteriosus and the other morbidities may not be causative and patent ductus arteriosus could be more a sign of immaturity and severity of disease than the cause of these problems. Non-steroidal anti-inflammatory agents, such as indomethacin or ibuprofen, have been shown to be effective in closing or preventing patent ductus arteriosus, with differences in side effects. However nearly all randomized controlled trials have been designed with the closure of the ductus arteriosus, not mortality or morbidity, as the main endpoint. Thus, evidence is still lacking on the eventual benefits for the patient of pharmacological or surgical intervention on PDA. Moreover, both ibuprofen and indomethacin efficacy seems markedly reduced in extremely low gestational age infants, who are the most likely to benefit from such intervention. The explanation of the reduced pharmacodymanic effect in such population is unclear; so far, studies using increased dosing of ibuprofen have failed to show a clear benefit. Prophylaxis with indomethacin or ibuprofen has failed to show sustained benefits on neurodevelopment at 2 years of age in low gestational age infants. New curative trials may aim at investigating the effects of early curative administration of ibuprofen, which has reduced side effects compared to indomethacin, on immature kidney function, on mortality and morbidity in very low gestational age infants, ideally with a combined endpoint such as survival in the absence of severe neurodevelopmental alteration at 2 years age. Despite an understandable reluctance given the historical background of systematic, therapeutic closure of ductus arteriosus in preterm infants, there are no definite ethical obstacles to a placebo-controlled design.     

早期预测早产儿动脉导管未闭的临床指标研究

目的 探讨可早期预测早产儿动脉导管未闭(patent ductus arteriosus,PDA)的临床指标。方法 采用前瞻性观察研究,选择2017年1—12月生后24 h内入住汕头大学医学院附属粤北人民医院治疗的61例早产儿(胎龄<37周)为研究对象,超声心动图检查存在早产儿症状性PDA(significant PDA,sPDA)的26例为观察组,无sPDA 的35例为对照组,其中观察组给予布洛芬混悬液口服治疗后,第1个疗程结束后复查超声心动图检查,仍存在sPDA的为持续开放组,无sPDA的为关闭组。生后检测血浆B型脑钠肽(BNP)、肌钙蛋白T(cTnT)、降钙素原(PCT)、神经元特异性烯醇化酶(NSE)、血小板计数(PLT),比较观察组与对照组、持续开放组与关闭组各临床指标间的差异,通过ROC曲线制定药物干预指征。结果 观察组血浆BNP、cTnT、NSE水平分别为(3 483.00±1 560.11)pg/mL、(89.17±35.67)pg/mL、(100.06±84.81)ng/mL,均高于对照组(2 380.65±1 105.15)pg/mL、(62.62±17.89)pg/mL、(60.69±35.17)ng/mL,差异有统计学意义(P=0.002、0.001、0.037);PCT、PLT水平在两组中差异无统计学意义(P >0.05)。各临床指标在关闭组与持续开放组中差异无统计学意义(P>0.05)。当NSE处于57.28 ng/mL时,灵敏度0.600,特异度0.618;BNP处于2 430.00 pg/mL 时,灵敏度0.800,特异度0.618;cTnT处于67.70 pg/mL 时,灵敏度0.680,特异度0.618,需要药物干预。结论 血浆BNP、cTnT、NSE在早期预测早产儿PDA及指导药物治疗方面具有重要意义。     

布洛芬与对乙酰氨基酚治疗早产儿症状性动脉导管未闭对患儿血浆和尿前列腺素E_2水平的影响

目的分析布洛芬与对乙酰氨基酚治疗早产儿症状性动脉导管未闭(sPDA)对患儿血浆和尿前列腺素E_2(PGE_2)水平的影响。方法纳入2014年7月至2016年12月我院出生的患有sPDA的84例早产儿作为观察对象。随机纳入42例给予布洛芬进行治疗(A组),另外42例给予对乙酰氨基酚治疗(B组)。对比两组治疗疗效,治疗前后血浆和尿PGE_2水平以及不良反应。结果两组患儿在各时段的关闭率以及总关闭率的组间差异均无统计学意义(P>0.05)。经治疗,两组患儿血浆PGE_2和尿PGE_2水平均较治疗前下降,与治疗前比较差异有统计学意义(P<0.05);A组下降程度稍大于B组,但组间差异均无统计学意义(P>0.05)。经治疗,两组患儿肝肾功能指标血肌酐(SCr)和丙氨酸氨基转移酶(ALT)水平均较治疗前略有上升(P>0.05),血小板(PLT)较治疗前有所下降,但差异无统计学意义(P>0.05);两组SCr、ALT及PLT水平比较差异无统计学意义(P>0.05)。B组高胆红素血症比例低于A组,组间差异有统计学意义(P<0.05),其他不良反应上,组间差异均无统计学意义(P>0.05)。结论布洛芬与对乙酰氨基酚的疗效相当,其对血浆PGE_2和尿PGE_2水平的影响略强于对乙酰氨基酚,但对乙酰氨基酚高胆红素血症的比例低于布洛芬。     

Comparative evaluation for the use of oral ibuprofen and intravenous indomethacin in Korean infants with patent ductus

Ductus arteriosus is a normal connecting blood vessel between the pulmonary artery and aorta in the fetus. However, if the ductus arteriosus is not closed and maintained as the open state even after 72 h of the birth, this is called a patent ductus arteriosus (PDA). Intravenous indomethacin is the conventional treatment for PDA in immature infants, but remains controversial in mature infants. The purpose of this study was to compare intravenous indomethacin and oral ibuprofen with regard to efficacy and safety for treatment of PDA. 78 neonates treated for PDA were included and classified into immature (n = 49) and mature (n = 29) groups. Ductal closure occurred in immature infants treated with indomethacin (74.1%) and ibuprofen (90.9%). Ductal closure occurred in mature infants treated with indomethacin (66.7%) and ibuprofen (92.9%). Platelet counts were increased in immature infants treated with ibuprofen (p = 0.027). Hyponatremia occurred in immature infants treated with ibuprofen (p = 0.002) and in both groups of mature infants (p = 0.001 for both groups). Serum creatinine values were lowered in mature infants treated with ibuprofen (p = 0.032). Bleeding occurred in 5 immature infants treated with indomethacin. Administration of furosemide for urine output was more frequent in the mature groups than in the immature group. In conclusion, oral ibuprofen was as effective as intravenous indomethacin in the immature groups and more effective in the mature groups. Adverse effects of oral ibuprofen were less severe than intravenous indomethacin.     

不同剂量布洛芬治疗动脉导管未闭极低出生体质量儿效果及安全性

目的:探究不同剂量布洛芬治疗动脉导管未闭(PDA)极低出生体质量儿的效果及安全性,为布洛芬治疗PDA极低出生体质量儿提供参考。方法:选取2017年2月30日至2019年4月30日我院收治的180例胎龄<37周且体质量<1500 g的PDA患儿,根据随机数字表法分为高剂量组90例和低剂量组90例。高剂量组患儿接受第1天20 mg/kg、第2天10 mg/kg、第3天10 mg/kg布洛芬治疗,低剂量组患儿接受第1天10 mg/kg、第2天5 mg/kg、第3天5 mg/kg布洛芬治疗,第一疗程失败患儿接受第二疗程治疗,治疗方法同第一疗程。观察两组患儿治疗后PDA关闭率、治疗期间不良反应发生率、病死率、治疗前后肺动脉端内径变化情况。结果:两组患儿治疗期间病死率及不良反应发生率比较差异均无统计学意义(P>0.05)。治疗第一疗程结束后高剂量组PDA治疗成功率高于低剂量组,PDA治疗失败率低于低剂量组(P<0.05)。第二疗程两组患儿PDA治疗成功率差异无统计学意义(P>0.05)。两组患儿两个疗程累计PDA治疗成功率比较差异有统计学意义(P<0.05)。治疗两个疗程后两组患儿动脉导管重新开放率比较差异无统计意义(P>0.05)。治疗前,两组患儿肺动脉端内径比较差异无统计学意义(P>0.05),治疗后两组患儿肺动脉端内径均低于治疗前(P<0.05),治疗第一、二个疗程后,高剂量组肺动脉端内径均低于低剂量组,差异有统计学意义(P<0.05)。结论:高剂量布洛芬治疗PDA极低出生体质量儿的效果优于低剂量,且安全性高。     

Pharmacologic management of patent ductus arteriosus

The incidence, pathophysiology, and clinical findings of symptomatic patent ductus arteriosus (PDA) are reviewed, and the pharmacologic management of symptomatic PDA is discussed. Spontaneous closure of the ductus arteriosus (DA) usually occurs within four days after birth in most premature and full-term infants. The incidence of PDA is related to birth weight in premature infants and has been shown to decrease with an increase in birth weight. Clinical findings are reviewed. Prophylactic treatment in the first few hours after birth may not be needed in most premature infants. Treatment should be considered only if the ductus becomes symptomatic. Medical management consists of respiratory support, fluid restriction, diuretics, digoxin, and indomethacin. Respiratory support, fluid restriction, and diuretics are used as first-line treatment of symptomatic PDA. Digoxin cannot be recommended as part of first-line therapy, since its risks seem to outweigh the benefits in preterm infants. Indomethacin should be used only if other standard measures including fluid restriction and diuretic treatment fail. The mechanism of action, pharmacokinetics, adverse effects, and drug interactions of indomethacin are discussed. Symptomatic PDA can increase morbidity and mortality, especially in very low birth weight infants. Treatment of symptomatic PDA may decrease the morbidity associated with this condition.     

不同给药途径治疗早产儿动脉导管未闭有效性和安全性的Meta分析

目的:系统评价不同药物给药途径治疗早产儿动脉导管未闭的有效性和安全性。方法:计算机检索PubMed、EMBase、the Cochrane Library、万方、中国知网、维普数据库,检索时间为建库至2021年9月6日。纳入采用口服用药(试验组)和静脉用药(对照组)治疗早产儿动脉导管未闭的随机对照试验,使用RevMan 5.3软件进行分析。结果:最终纳入5篇文献进行Meta分析,共330例患儿。Meta分析结果显示,口服用药组动脉导管闭合率与静脉用药组比较差异无统计学意义(RR=1.04,95%CI 0.96～1.12,P=0.39),两组患儿相关不良反应发生率、病死率及住院时间比较差异无统计学意义(P>0.05)。结论:当前证据表明,口服用药与静脉用药治疗PDA的有效性和安全性无明显差异。受研究数量和质量的影响,仍需开展更多高质量的随机对照研究探讨不同给药途径对不同特征、用药时机的早产儿PDA闭合的影响。     

布洛芬混悬液联合氢化可的松治疗早产儿动脉导管未闭的临床研究

目的探讨布洛芬混悬液联合醋酸氢化可的松片治疗早产儿动脉导管未闭的临床疗效。方法选取2013年8月—2016年8月天津市蓟州区人民医院儿科收治的动脉导管未闭早产儿134例作为研究对象,依据患者治疗方式不同分为布洛芬组(44例)、氢化可的松组(44例)和联合组(46例)。布洛芬组口服布洛芬混悬液,首次剂量10 mg/kg,第2、3剂量5 mg/kg,每次间隔24 h,共3次。氢化可的松组口服醋酸氢化可的松片,1片/次,1次/d,治疗3 d。联合组给予布洛芬混悬液和醋酸氢化可的松片治疗,方法同上。观察3组的临床疗效,比较3组的前列腺素E2(PGE2)、N末端B型脑钠肽(NT-pro BNP)、内皮素-1(EF-1)和心功能指标。结果治疗后,布洛芬组、氢化可的松组和联合治疗组动脉导管未闭关闭率分别为84.09%、79.55%、93.48%,联合治疗组动脉导管未闭关闭率高于布洛芬组和氢化可的松组,3组比较差异有统计学意义(P0.05)。治疗后,3组血浆PGE2、尿PGE2、NT-pro BNP和EF-1水平均明显下降,同组治疗前后比较差异具有统计学意义(P0.05);且联合组这些观察指标明显低于布洛芬组和氢化可的松组,差异具有统计学意义(P0.05)。治疗后,3组左心室收缩末前后径(LVESD)、左心室舒张末前后径(LVEDD)、左心室收缩末容量(LVESV)和左心室舒张末容量(LVEDV)均明显下降,同组治疗前后比较差异有统计学意义(P0.05);且联合组这些观察指标明显低于布洛芬组和氢化可的松组,差异具有统计学意义(P0.05)。联合组高胆红素血症、消化道出血发生率均低于布洛芬组和氢化可的松组,3组比较差异具有统计学意义(P0.05)。结论布洛芬混悬液联合醋酸氢化可的松片治疗早产儿动脉导管未闭具有较好的临床疗效,降低了患儿PGE_2、NT-pro BNP、EF-1水平,改善患儿心功能指标,安全性较好,具有一定的临床推广应用价值。     

Pharmacokinetics of oral ibuprofen in premature infants

Patent ductus arteriosus (PDA) is a frequent complication in premature infants. So far, intravenous indomethacin is the standard mode of medical therapy in such patients but carries a risk of frequently occurring side effects. Ibuprofen, another nonsteroidal anti-inflammatory drug, has also been shown to be efficacious in closing ductus with lesser adverse effects after parenteral administration. However, limited data are available on the pharmacokinetics of intravenous ibuprofen in this population. Nonavailability of parenteral preparation and lack of information regarding pharmacokinetic disposition of ibuprofen in this subgroup of the population led the authors to conduct this pharmacokinetic study with oral ibuprofen. Twenty premature infants with a gestational age of 30.45 +/- 0.33 weeks and a birth weight of 1262.5 +/- 55.4 g (values given as mean +/- SEM) admitted to the neonatal unit were enrolled in this study. Ibuprofen was administered in a single oral dose of 10 mg/kg between 4 and 72 hours postnatally, and blood samples were collected through an indwelling vascular catheter at time 0 and 1, 2, 4, 8, 12, and 24 hours. Ibuprofen plasma concentrations were assayed by high-performance liquid chromatography. There was a large interindividual variability observed for plasma concentrations, elimination half-life (t1/2) (15.72 +/- 3.76 h), and area under the plasma concentration-time curve (AUC0-infinity) (402.60 +/- 79.67 micrograms.h/mL) in these babies. Variables such as gestational age, birth weight, and sex did not affect ibuprofen pharmacokinetics significantly (p > 0.05). Moreover, no correlation could be found between elimination half-life and gestational age (r = 0.02). Ibuprofen pharmacokinetics showed a wide variability in premature infants. The results of the present study warrant revising the oral dosage schedule to achieve comparable plasma concentrations of ibuprofen associated with successful closure of ductus, as reported in earlier studies.