Comparison of Ibuprofen and Indomethacin for Treatment of Patent Ductus Arteriosus (PDA) in Preterm and Term Infant

Kim, Jeong A; Lee, Soon Min; Park, Min Soo; Park, Kook In; Namgung, Ran; Lee, Chul

Abstract

PURPOSE
Ibuprofen and indomethacin has been used in treatment of patent ductus arteriosus (PDA). In Korea, we have a little experience about ibuprofen. We aim to evaluate effect and adverse reaction of two medications in preterm and term infants.
METHODS
The medical records of 24 infants who were admitted at Gangnam Severance hospital NICU diagnosed as PDA and underwent indomethacin treatment from November 2009 to July 2010, and 22 infants who underwent ibuprofen treatment from March 2009 to October 2009 were analyzed. Diagnostic criteria showed as the diameter of ductus arteriosus measured was 1.5 mm and left atrium to aortic root ratio was 1.3 by echocardiography with significant clinical symptom.
RESULTS
There was no significant difference between ibuprofen and indomethacin group in gestational age, birth weight, Apgar score and diameter of ductus arteriosus. The rate of PDA closure for 1st trial showed 79% (19/24) in ibuprofen group and 72% (16/22) in indomethacin group. For 2nd trial the rate was 80% (4/5) and 71% (5/7) respectively. There was no difference between two groups in the ratio of increased serum creatinine level, decreased urine output and cumulative dose of furosemide. Incidence of gastrointestinal bleeding, intraventricular hemorrhage and chronic lung disease showed no significant difference between two groups. For term infants, the rate of closure is similar between two groups.
CONCLUSION
There was no difference in effect for PDA closure between ibuprofen and indomethacin in preterm and term infants. In addition, there was no significant difference in the rates of adverse reaction between ibuprofen and indomethacin.