Prophylaxis of symptomatic patent ductus arteriosus with oral ibuprofen in very low birth weight infants.
BACKGROUND
Patent ductus arteriosus (PDA) is a common cause of mortality and morbidity among very low birth weight infants. Oral ibuprofen suspension has been shown to have the same efficacy and safety as intravenous indomethacin in the prevention and treatment of symptomatic PDA. With lower dosage, the prevalence of side effects may decrease without changes in efficacy.


OBJECTIVE
To evaluate the efficacy and side effects of low dose ibuprofen suspension for prevention of symptomatic PDA in very low birth weight infants.


METHODS
A prospective, double blind, randomized controlled trial was conducted on premature neonates with gestational ages between 28-32 weeks, birth weight 1500 grams or less, at the Neonatal Unit, Queen Sirikit National Institute of Child Health (QSNICH) during October 2005 to October 2006. Only infants who had PDA on echocardiogram were included in the study. Three doses of ibuprofen suspension or placebo were randomly given at the dosage of 10, 5, 5 mg/kg every 24 hours. Daily physical examination, serial laboratory evaluation and echocardiogram were used to evaluate symptomatic PDA, complications and side effects.


RESULTS
Sixty-two infants were recruited in the study and randomly assigned into the study and control group. The gestational age and birthweight of the 2 groups were similar The prevalence of symptomatic PDA was less in the ibuprofen group than in placebo group (9.86% vs. 35.48%; p = 0.015). There were no differences in the prevalence of complications and adverse effects between the two groups.


CONCLUSIONS
Prophylactic oral ibuprofen suspension at lower dosage results in less symptomatic PDA without significant side-effects.
Sangtawesin
Chaisit
C
Cardiology Unit, Department of Pediatrics, Queen Sirikit National Institute of Child Health, Department of Medical Services, Thailand.
Sangtawesin
Varaporn
V
Lertsutthiwong
Watcharee
W
Kanjanapattanakul
Wiboon
W
Khorana
Meera
M
Ayudhaya
Jintakan Kasamesri Na
JK
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D004374:Ductus Arteriosus, Patent / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000008:administration & dosage / Q000627:therapeutic use*; D007223:Infant; D007229:Infant Welfare; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008297:Male; D015995:Prevalence; D013785:Thailand / Q000453:epidemiology; D014463:Ultrasonography
D000894:Anti-Inflammatory Agents, Non-Steroidal; D007052:Ibuprofen