Improved Closure of Patent Ductus Arteriosus With High Doses of Ibuprofen
| Autor: | Udo Meißner, Wolfgang Rascher, Hans-Georg Topf, Raktima Chakrabarty, Michael Schroth |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
congenital
hereditary and neonatal diseases and abnormalities medicine.medical_specialty health care facilities manpower and services education Ibuprofen Severity of Illness Index health services administration Ductus arteriosus medicine High doses Humans Cyclooxygenase Inhibitors Cardiac Surgical Procedures Closure (psychology) Ductus Arteriosus Patent Retrospective Studies Dose-Response Relationship Drug business.industry Incidence (epidemiology) Body Weight Infant Newborn Retrospective cohort study Vascular surgery Surgery Cardiac surgery Treatment Outcome medicine.anatomical_structure Echocardiography Anesthesia Injections Intravenous Pediatrics Perinatology and Child Health Cardiology and Cardiovascular Medicine business Follow-Up Studies medicine.drug |
| Zdroj: | Pediatric Cardiology. 33:586-590 |
| ISSN: | 1432-1971 0172-0643 |
| DOI: | 10.1007/s00246-012-0182-2 |
| Popis: | The patent ductus arteriosus (PDA) is associated with various complications of prematurity. Cyclooxygenase-inhibitors are the first-line intervention for closure of the PDA. However, the rates of PDA closure still are unsatisfactory. Therefore, an individual trial was performed by changing the strategy for treating neonates with ibuprofen to induce the closure of PDA. In a retrospective study, patients receiving 20, 10, and 10 mg/kg bodyweight ibuprofen (group 1) were compared by chart review with those receiving 10, 5, 5 mg/kg (group 2). The rate of PDA closure, the incidence of side effects related to the use of ibuprofen, and the need for surgical intervention for closure of the PDA were analyzed. A higher rate of closure after three doses in group 1 could be observed (60.9 vs 52.6%; p = 0.75), which was not significant but indicated a clear positive trend. If closure of the PDA was unsuccessful, intravenous ibuprofen was continued for an additional 2 days. After 5 days, 91.3% of PDA in group 1 was closed compared with 68.4% PDA in group 2. In summary, only 8.7% of the group 1 neonates needed surgical closure of PDA after insufficient medicamentous closure compared with 31.6% in group 2 (p = 0.25). Although not statistically significant, a clear positive trend for using the higher-dose medication can be seen. More work dealing with the limitations of a retrospective study must be done. Based on the data from this study, high-dose ibuprofen seems able to increase the rate of effective medicamentous PDA closure without any further unwanted side effects. |
| Databáze: | OpenAIRE |
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