title: Non-steroid anti-inflammatory drugs in the treatment of patent ductus arteriosus in European newborns.
abstract: BACKGROUND
  Patent ductus arteriosus (PDA) is a common cause of morbidity and mortality among very low birth weight infants and must be treated on an individual basis. Non-steroid anti-inflammatory drugs (NSAIDs) have been used in the treatment of PDA. However, no general guidelines have been followed.
  
  
  OBJECTIVE
  To know the European reality on NSAIDs in the treatment of PDA in preterm newborns.
  
  
  METHODS
  A questionnaire was sent to 24 European Societies of Neonatology and Perinatology to be filled, at least, by two neonatal intensive care units (NICUs) in each country, and to three representatives NICUs in Europe.
  
  
  RESULTS
  We received 45 filled forms from 19 countries: 1 (2%) from North, 12 (27%) from East, 6 (13%) from West, and 26 (58%) from South Europe. Intravenous (iv) indomethacin is used in 32 (71%) NICUs (88% use a 30-60 min perfusion), iv ibuprofen in 16 (36%), and oral ibuprofen in 13 (29%). In 45% of NICUs a second course is used; 27% prescribed a third one. Prolonged treatment, 4-6 days, is mentioned by 45% of NICUs, in extremely low birth eight infants and after the failure of 3 courses of treatment. Prophylactic treatment is used in two NICUs, 24% treat no hemodynamically significant PDA, 96% treat with NSAIDs hemodynamically significant PDA and one NICU uses surgical closure as first line treatment. The ibuprofen/indomethacin contra-indications and preferences are similar to the literature. Pedea is the iv ibuprofen solution used and oral ibuprofen is a solution with 20 mg/ml. The choices are influenced by economical reasons in 22% of NICUs.
  
  
  CONCLUSIONS
  Our data show a wide variation among NICUs and countries, regarding the use of NSAIDs to treat PDA, and that no general guidelines are followed. Guidelines or recommendations are necessary to standardize treatment of PDA in Europe, in order to give to all newborns identical health care opportunities.
authors.affiliation: NICU, São João Hospital, Porto University, Portugal. herciliaguimaraes@gmail.com
authors.forename: Hercília
authors.initials: H
authors.lastname: Guimarães
authors.forename: Gustavo
authors.initials: G
authors.lastname: Rocha
authors.forename: Teresa
authors.initials: T
authors.lastname: Tomé
authors.forename: Fani
authors.initials: F
authors.lastname: Anatolitou
authors.forename: Kosmas
authors.initials: K
authors.lastname: Sarafidis
authors.forename: Vassilios
authors.initials: V
authors.lastname: Fanos
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D000075202:Contraindications; D003625:Data Collection; D004232:Diuretics / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004374:Ductus Arteriosus, Patent / Q000188:drug therapy*; D005060:Europe; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000188:drug therapy*; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal; D010818:Practice Patterns, Physicians'
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D004232:Diuretics