Perinatology.  2018 Mar;29(1):33-38. 10.14734/PN.2018.29.1.33.

The Comparison of Efficiency of Oral Ibuprofen and Intravenous Indomethacin for Patent Ductus Arteriosus in Very Low Birth Weight Infants

• Yun JW
• Park HA
• Hwang JH

• KMID: 2409110
• DOI: http://doi.org/10.14734/PN.2018.29.1.33

Abstract

OBJECTIVE
Intravenous indomethacin is the conventional treatment for closure of patent ductus arteriosus (PDA) in preterm infants. However, there are very few studies about oral ibuprofen in preterm infants with PDA. Therefore, this study was done to evaluate the efficacy and side effects of oral ibuprofen compared to intravenous indomethacin in very low birth weight (VLBW) infants.
METHODS
From March 2008 to August 2012, medical records of 103 infants with VLBW who had PDA in Inje University Ilsan Paik Hospital were reviewed retrospectively. The medical treatment was given to the 90 infants with hemodynamically significant PDA. Patients were divided into the intravenous indomethacin (IV indo) group (n=27) and the oral ibuprofen (per oral [PO] ibu) group (n=63). Demographic findings and factors associated with PDA were compared between these groups.
RESULTS
There were no significant differences in the mean gestational age, birth weight, and demographic findings between the two groups. The conditions such as respiratory distress syndrome and PDA size were not different before treatment. The rate of ductal closure was 100% in IV indo and 95% in PO ibu. 3 infants in only PO ibu needed surgical closure. Blood urea nitrogen and Creatinine levels did not increase significantly in PO ibu compared with IV indo, and there was no notable increase in necrotizing enterocolitis or oliguria incidence in this group either. There were no significant differences in the mortality and late complications.
CONCLUSION
Oral ibuprofen is as efficacious as intravenous indomethacin with similar adverse effects.

Keyword

Ductus arteriosus; Patent; Ibuprofen; Indomethacin

MeSH Terms

Birth Weight
Blood Urea Nitrogen
Creatinine
Ductus Arteriosus
Ductus Arteriosus, Patent*
Enterocolitis, Necrotizing
Gestational Age
Humans
Ibuprofen*
Incidence
Indomethacin*
Infant*
Infant, Newborn
Infant, Premature
Infant, Very Low Birth Weight*
Medical Records
Mortality
Oliguria
Retrospective Studies
Creatinine
Ibuprofen
Indomethacin

Figure

• 

  Fig. 1. Diagram of patent ductus arteriosus in very low birth weight infants. PDA, patent ductus arteriosus; VLBW, very low birth weight; IV, intravenous; PO, per oral.

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