Ductus Arteriosus Patent/surgery

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Original Article

What Should be the First-line Treatment for the Closure of Hemodynamically Significant Patent Ductus Arteriosus in Premature Infants?

Abstract

Background

It is important which medicine to use as a first-line treatment to close the duct.

Objectives

The aim of this study is to compare the effectiveness and side effects of intravenous (IV) forms of ibuprofen and paracetamol and to contribute to the literature investigating the first drug selected in the medical treatment of patent ductus arteriosus (PDA).

Methods

Our study was conducted between January 2017 and December 2019. Premature infants with birth weight (BW) ≤1500 g and gestational age (GA) ≤32 weeks were included in the study. In the study period, all infants with hemodynamically significant patent ductus arteriosus (hsPDA) were given rescue intravenous (IV) ibuprofen as a primary medical treatment or IV paracetamol treatment if there were contraindications for ibuprofen. The patients were divided into two groups: patients receiving IV ibuprofen and patients receiving IV paracetamol.

Results

Of these patients, 101 were given IV paracetamol and 169 were given IV ibuprofen. The success rate of PDA closure with first-course treatment was 74.3% in the IV paracetamol group and 72.8% in the IV ibuprofen group (p=0.212).

Conclusions

Our results show that IV paracetamol is as effective as IV ibuprofen in the first-line treatment of hsPDA, and can become the preferred treatment for the management of hsPDA.

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Clinicoradiological Correlation

Case 6 / 2018 – Percutaneous Occlusion of a Large Ductus Arteriosus in a Low Weight Infant, with Immediate Clinical and Radiographic Improvement

Pablo Tomé Teixeirense et al. Vanessa de Moraes Sousa João Felipe Barros de Toledo Luiz Antonio Gubolino

Clinical Data

The patient was a one-year-old infant with Down syndrome, and heart murmur auscultated from birth. The child had a difficult clinical course due to failure to thrive, tachypnea, poor suckling due to fatigue and repeated respiratory infections, with pulmonary hypersecretion, and was receiving captopril and furosemide.

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