Oral Ibuprofen Therapy for Patent Ductus Arteriosus in Very Low Birth Weight Infants

Document Type : Original Article

Abstract

Background- Patent ductus arteriosus is found in 45% of infants under 1500gr and in infants
weighing < 1000gr, the incidence is closer to 80%. Indomethacin has been shown to close the
ductus arteriosus in a large fraction of premature infants. Intravenous ibuprofen was recently
shown to be as effective and to have fewer adverse reactions in preterm infants. If equally
effective, then oral ibuprofen for patent ductus arteriosus (PDA) closure would have several
important advantages over the intravenous route. This study was designed to determine
whether oral ibuprofen treatment is efficacious and safe in closure of PDA in very low birth
weight infants with respiratory distress syndrome (RDS).
Methods- 30 preterm newborns (gestational age 28.3±2.6 weeks), mean weight 1130±312gm, with
PDA and RDS were studied prospectively. They received oral ibuprofen suspension
10mg/kg/body weight for the first dose, followed at 24 hour intervals by two additional doses
of 5mg/kg each, if needed, starting on the second day of life. Echocardiographies were
performed before treatment and 24 hours after the second dose. The rate of ductal closure, the
need for additional treatment, side effects, complications and the infants’ clinical courses
were recorded.
Results- Ductal closure was achieved in 28 newborns (93.3%), and in two others partial closure was
achieved with no important shunts persisting. No infants required surgical ligation of ducts.
There was no reopening of the ductus after closure had been achieved. 21 newborns were
treated with one dose of ibuprofen, five were treated with two doses and the remaining two
were treated with three doses. There were no significant differences in the levels of serum
creatinine before and after treatment with oral ibuprofen.
Conclusion- Oral ibuprofen suspension may be an effective and safe alternative for PDA closure in
premature infants with PDA. However larger comparative studies are warranted (Iranian
Heart Journal 2008; 9 (2):23-28).

Keywords

Fatemeh Haji Ebrahim Tehrani MD, Hadi Kazemi MD, Saied Mojtahedzadeh MD*, Jahan Oudj MD

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Iranian Heart Journal
Volume 9, Issue 2
June 2008
Pages 23-28

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