Early paracetamol treatment associated with lowered risk of persistent ductus arteriosus in very preterm infants. (August 2014)

• Record Type: Journal Article
• Authors: Aikio, Outi; Härkin, Pia; Saarela, Timo; Hallman, Mikko
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 27:Number 12(2014:Dec.)
• Page Start: 1252
• Page End: 1256
• Publication Date: 2014-08
• Subjects: Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• DOI: 10.3109/14767058.2013.854327
• Languages: English
• ISSNs: 1476-7058

Abstract

<abstract> <title>Abstract</title> <p> <italic>Objectives:</italic> Persistent ductus arteriosus (PDA) delays the recovery of very preterm infants (VLGA, gestation <32 weeks). Indomethacin/ibuprofen treatment and ligation of PDA have complications. As a prostaglandin synthase inhibitor paracetamol may also promote the closure of ductus arteriosus. We studied retrospectively whether early paracetamol therapy was associated with decreased incidence of PDA without adverse events.</p> <p> <italic>Methods:</italic> On June 2009, we introduced intravenous paracetamol during early respiratory therapy. We included 105 VLGA infants who received paracetamol before the age of 72 h. The loading dose was 20 mg/kg followed by 7.5 mg/kg every 6 hours. The 96 VLGA infants admitted from January 2008 to May 2009 without lethal congenital disease were controls. Infants dying very early were excluded, leaving 102 paracetamol-exposed and 88 controls for analysis.</p> <p> <italic>Results:</italic> After the introduction of paracetamol, the incidence of PDA decreased from 30.7% to 14.7% (<italic>p</italic> = 0.008). Ibuprofen treatment was given to 15 paracetamol-treated and to 26 control infants (<italic>p</italic> = 0.013). Three paracetamol-exposed and seven control infants required surgery. There was no detectable increase in adverse events.</p> <p> <italic>Conclusions:</italic> Annual incidence of PDA decreased after introduction of paracetamol. Efficacy and safety in promoting the early closure of ductus arteriosus remains to be established.</p> </abstract>