Showing 4 results for Patent Ductus Arteriosus
Jafari Fesharaki H, Nayeri Fs, Akbari Asbaq P, Amini E, Sedaqat M,
Volume 70, Issue 8 (11-2012)
Abstract
Background: Patent ductus arteriosus (PDA) is a common finding among premature or low-birth-weight infants and it often does not close. Nowadays, drugs used for its treatment include indomethacin and more commonly ibuprofen. Oral ibuprofen was recently shown to be as effective and have several important advantages in preterm infants. Studies performed to find the best dose of ibuprofen for PDA treatment are limited hence, we compared the effects of two different doses of ibuprofen in this interventional study.
Methods: In this randomized controlled clinical trial, we randomly divided 60 patients with echocardiographically confirmed PDA into two groups of 30. This study was done in NICU of Valiasr hospital in 1387-89 years. In the first group, we administered a loading dose of 10 mg/kg ibuprofen on the first day, followed by two doses of 5 mg/kg in the next two days. In the second group, we administered a loading dose of 15 mg/kg ibuprofen on the first day followed by two doses of 7.5 mg/kg in next two days. Eventually, we compared PDA closure rates and complications of therapy between the two groups.
Results: Thirty (100%) patients in 15-mg/kg group and 23 (76.7%) patients in 10 mg/kg group had successful PDA closure with no need for surgery. The two groups had a statistically significant difference (P=0.011) and the highest response to treatment was seen within the first 24 hours of treatment.
Conclusion: We may conclude that higher doses of ibuprofen (15 and 2×7.5 mg/kg) would offer better outcomes for PDA closure without gastrointestinal or renal complications and less need for surgery.
Parvin Akbari Asbagh , Mohammad Reza Zarkesh , Firoozeh Nili , Fatemeh Sadat Nayeri , Azam Tofighi Naeem ,
Volume 73, Issue 2 (5-2015)
Abstract
Background: The incidence of Patent Ductus Arteriosus (PDA) in premature infants whose birth weight is less than 1500 grams is approximately 30-60%, most of them need medical or surgical interventions. The purpose of this study is to determine the efficacy of prophylactic treatment with oral paracetamol (Acetaminophen- Hakim® Oral Drops 100 mg/ml, Hakim Pharmaceutical Co., Tehran, Iran) for PDA in preterm infants.
Methods: A randomized clinical trial conducted from March 2012 to March 2013. Thirty-two preterm newborns whose gestational age was under 32 weeks and birth weight was 1500 grams or less, admitted in neonatal intensive care unit (NICU) of Vali-Asr Hospital, Tehran were studied prospectively. They were randomly assigned in two groups. The prophylaxis group received oral paracetamol for a period of two days starting during first 24 hours of life. No placebo was given to the control group. Echocardiography was performed 24-36 hours after the last given dose in prophylaxis group and on the 4th and 5th day in control group. A p-value less than 0.05 are considered significant.
Results: There were 16 newborns in each group (20 boys and 12 girls). In 12 newborns of prophylaxis group the ductus arteriosus was closed although in control group in 8 newborns the duct was closed. No significant difference was observed in sex, gestational age, birth weight, mode of delivery, multifetal gestation and birth order between two groups. The rate of ductal closure was 75% and 50% in prophylaxis group and control group respectively (P=0.27).
Conclusion: Our study demonstrated that prophylactic paracetamol is ineffective in PDA closure, although the rate of ductal closure between two groups seems remarkable. Paracetamol as a new strategy for PDA closure because of cost effectiveness and harmlessness may be used in future. However, we presume larger sample size studies are needed to show the efficacy of paracetamol, side effects, and complications in PDA prophylaxis treatment.
Semira Mehralizadeh, Majid Mirmohammmadkhani, Aylin Kalantarzade ,
Volume 77, Issue 8 (11-2019)
Abstract
Background: Previous studies have considered patent ductus arteriosus (PDA) a common finding in premature infants, leading to complications such as intracranial hemorrhage, necrotizing enterocolitis and pulmonary dysplasia. The aim of this study was to assess and compare the efficacy of oral ibuprofen and intravenous acetaminophen in the closure of arterial duct in premature newborns. We also evaluated the complications of each drug.
Methods: A cross-sectional and analytical study was conducted at Amiralmomenin Hospital, Semnan City in Iran from April 2012 to December 2017. Subjects were selected through convenient sampling and consisted of all premature infants with patent arterial duct. All of the infants with the diagnosis of PDA were treated with either intravenous acetaminophen or oral ibuprofen. Cardiac echocardiographic findings were assessed in two study groups before and after each treatment course. The complications associated with the two treatment approaches were evaluated in two groups after treatment of each drug.
Results: In general, twenty-four neonates (62.5% females) with the average gestational age of 31.46±3.43 weeks were studied. There was no significant difference in the echocardiographic characteristics in the two treatment groups at the pre and post-treatment periods as well as the side effects of the medications. The average number of treatment cycles in newborns treated with oral ibuprofen (1.06±0.25) was not significantly different compared to those with intravenous acetaminophen (1.25±0.46) (P=0.190). There was no significant difference concerning closure status of the arterial duct in the two treatment groups at the end of the first period (P=0.112) as well as after the second period of treatment (P=0.386).
Conclusion: Our study indicated similar efficacy of oral ibuprofen and intravenous acetaminophen in the closure of the arterial duct. The incidence of complications was not significantly different between the two groups. The results of this study suggest the use of intravenous acetaminophen as a suitable drug for PDA closure, particularly in cases of ibuprofen contraindications.
Manouchehr Soltani , Bahman Sadeghi Sedeh , Gholamali Fattahi Bayat , Parasto Mollai Tavana , Mojtaba Ahmadlou ,
Volume 80, Issue 3 (6-2022)
Abstract
Background: This study aimed to assess the efficacy and safety of the oral use of ibuprofen suspension in various doses in the treatment of PDA (Patent ductus arteriosus) in mature babies. Mature babies (37-42 weeks) aged more than 3 days who had been diagnosed with PDA were involved in this study. For the measurement of the ratio of left atrial to aortic root diameters (La/Ao) Color, pressure gradient and the internal ductal diameter, Doppler echocardiography (ECHO) was performed. This clinical trial was performed on 60 infants born born between August 2013 to August 2015.
Methods: This clinical trial study was performed on 60 infants were randomly born between August 2013 to August 2015 which Randomly divided into two groups: The first group, received oral ibuprofen in three doses (5, 5, 10 mg/kg at 24-hour intervals) and the second group received an early dose of OIS, in two doses of 10 mg/kg after 24 and 48 hours (totally 20 mg/kg). A follow-up ECHO was performed 48 hours and 2 weeks after treatment by the same pediatric cardiologist who was not aware of the study groups. Evaluation of changes in platelet count, blood urea nitrogen, creatinine and complications of thrombocytopenia, evaluation of elevated serum creatinine, and complications of gastrointestinal bleeding were compared between the two groups using statistical analysis.
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Results: Seventy-three percent (73%) patients in the first group and seventy-six (76%) patients in the second group had successful PDA closure in the first 48 hrs. No statistically significant difference between the two groups (P=0.0001) was obtained and the highest response time was observed in the first 48 hours of treatment. After 2 weeks, the PDA closure in both groups was completely successful (100%). No specific side effects were observed between the two groups.
Conclusion: We conclude that higher doses of ibuprofen (20 and 2×510 mg/kg) do not show better results for PDA closure without renal or gastrointestinal complications.
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