Neonatal Med.  2017 May;24(2):83-87. 10.5385/nm.2017.24.2.83.

Can Treatment of Patent Ductus Arteriosus with Ibuprofen Compared to Supportive Management Affect Regional Brain Volume in Very Low Birth Weight Infants? A Pilot Study

• Koo JH
• Lee KN
• Kim HG
• Lee KM
• Choi YS

• KMID: 2379659
• DOI: http://doi.org/10.5385/nm.2017.24.2.83

Abstract

PURPOSE
This study aimed to compare cerebral hemispheric volumes between pharmacologic treatment and supportive management of patent ductus arteriosus (PDA).
METHODS
The study was conducted retrospectively. The subjects of period 1 group were very low birth weight infants whose PDA were treated with pharmacologic closure. Period 2 group were treated with supportive management. Regional brain volumes measured using magnetic resonance imaging were compared between the two groups.
RESULTS
total of 12 infants were included. Their median gestational age was 27⁺⁶ (range: 24⁺¹-31⁺¹) weeks and birth weight was 1,065 g (range: 690-1,380). Between the two groups, there was no difference in Apgar score, incidence of bronchopulmonary dysplasia, necrotizing enterocolitis, and culture proven sepsis. The regional brain volumes such as gray matter (Period 1 group, 76,833 mm³ [55,759-100,388] vs. Period 2 group, 79,870 mm³ [59,957-113,018], P=0.59), white matter (82,993 mm³ [63,130-121,311] vs. 92,576 mm³ [77,200-104,506], P=0.18), cerebrospinal fluid (17,167 mm³ [9,279-22,760] vs. 14,348 mm³ [7,018-27,604], P=0.94), basal ganglia (2,065 mm³ [1,697-2,482] vs. 2,306 mm³ [2,065-3,009], P=0.18), and cerebellum (18,374 mm³ [14,843-24,657] vs. 18,096 mm³ [16,134-23,627], P=0.94) were not different between the two groups.
CONCLUSION
Regional brain volumes were not different between pharmacological and conservative treatment in infants with PDA. Further wellcontrolled studies are required to evaluate the advantages or disadvantages of supportive management without pharmacologic treatment of PDA.

Keyword

Patent ductus arteriosus; Preterm infants

MeSH Terms

Apgar Score
Basal Ganglia
Birth Weight
Brain*
Bronchopulmonary Dysplasia
Cerebellum
Cerebrospinal Fluid
Ductus Arteriosus, Patent*
Enterocolitis, Necrotizing
Gestational Age
Gray Matter
Humans
Ibuprofen*
Incidence
Infant*
Infant, Newborn
Infant, Premature
Infant, Very Low Birth Weight*
Magnetic Resonance Imaging
Pilot Projects*
Retrospective Studies
Sepsis
White Matter
Ibuprofen