Enteral paracetamol or Intravenous Indomethacin for Closure of Patent Ductus Arteriosus in Preterm Neonates: A Randomized Controlled Trial.
نویسندگان
چکیده
OBJECTIVE To compare the efficacy of enteral paracetamol and intravenous indomethacin for closure of patent ductus arteriosus (PDA) in preterm neonates. DESIGN Randomized controlled trial. SETTING Level III neonatal intensive care unit. PARTICIPANTS 77 preterm neonates with birth weight ?1500 g and PDA size ?1.5 mm, with left to right ductal flow with left atrium to aortic root ratio >1.5:1; diagnosed by 2D-Echo within first 48 hours of life. INTERVENTION Paracetamol drops through the infant feeding tube (15 mg/kg/dose 6 hourly for 7 days) or intravenous indomethacin (0.2 mg/kg/dose once daily for 3 days). OUTCOME MEASURES Primary: PDA closure rate assessed by echocardiography. Secondary: need for surgical closure of PDA, renal impairment, gastrointestinal bleed, necrotising enterocolitis, hepatotoxicity, pulmonary hemorrhage, sepsis, hypothermia, retinopathy of prematurity, intraventricular hemorrhage, bronchopulmonary dysplasia and mortality. RESULTS PDA closure rate was 100% (36/36) in enteral paracetamol group as compared to 94.6% (35/37) in intravenous indomethacin group (P=0.13). The secondary outcomes were also similar between the two groups. There was no occurrence of hepatotoxicity. CONCLUSIONS Enteral paracetamol is safe but not superior to intravenous indomethacin in the treatment of PDA in preterm neonates.
منابع مشابه
Intravenous Paracetamol and Patent Ductus Arteriosus Closure
Background: Standard medical treatments for patent ductus arteriosus (PDA) closure are, including indomethacin/ibuprofen and surgical ligation. Nowadays, a new strategy to close PDA is the use of paracetamol. The present study aimed to describe the use of intravenous (IV) paracetamol for PDA closure in neonates who present a contraindication to ibuprofen or ibuprofen failure with no possibility...
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ورودعنوان ژورنال:
- Indian pediatrics
دوره 52 7 شماره
صفحات -
تاریخ انتشار 2015