Korean J Perinatol.  2014 Dec;25(4):257-265. 10.14734/kjp.2014.25.4.257.

Risk Factors of Failure of Ibuprofen Treatment in Preterm Infants with Hemodynamically Significant Patent Ductus Arteriosus

• Kwon NH
• Lee JH
• Jeon GW
• Sin JB

• KMID: 2281143
• DOI: http://doi.org/10.14734/kjp.2014.25.4.257

Abstract

PURPOSE
In this study, the risk factors of failure of ibuprofen treatment in preterm infants with hemodynamically significant patent ductus arteriosus (hsPDA) were investigated.
METHODS
Among 403 preterm infants (<32 weeks gestation) born between January 2010 and December 2012, 125 infants treated with ibuprofen for hsPDA were retrospectively reviewed. The preterm infants were divided into the following groups according to their response to the 1st and 2nd cycles of ibuprofen treatment: responder groups I and II, closure of the ductus arteriosus after the 1st and 2nd cycles of ibuprofen treatment; and non-responder groups I and II, persistency of hsPDA after the 1st and 2nd cycles of ibuprofen treatment.
RESULTS
One hundred twenty five infants were enrolled in the study: 74 in responder group I, 51 in non-responder group I, 14 in responder group II, and 22 in non-responder group II. In non-responder group I, the gestational age and birth weight were smaller, the postnatal steroid treatment was more frequent, and the duration of mechanical ventilation and the days spent in the hospital were prolonged.I n non-responder group II, the gestational age and birth weight were smaller, the diameters of the ductus arteriosus were larger, and the inotropics use was more frequent.
CONCLUSION
Failure of ibuprofen treatment of hsPDA is associated with the diameter of the ductus arteriosus and with inotropics use. Obtaining data regarding these is expected to help in determining if early direct surgical ligation is needed.

Keyword

Patent ductus arteriosus; Preterm infants; Ibuprofen

MeSH Terms

Birth Weight
Ductus Arteriosus
Ductus Arteriosus, Patent*
Gestational Age
Humans
Ibuprofen*
Infant
Infant, Newborn
Infant, Premature*
Ligation
Respiration, Artificial
Retrospective Studies
Risk Factors*
Ibuprofen

Figure

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  Fig. 1. Derivation of study groups.

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