title: Unbound bilirubin does not increase during ibuprofen treatment of patent ductus arteriosus in preterm infants.
abstract: OBJECTIVE
  To determine whether ibuprofen displaces bilirubin from albumin in preterm infants.
  
  
  METHODS
  A total of 34 preterm neonates (<32 weeks gestation) treated by ibuprofen (10-5-5 mg/kg) were included in this prospective open-label study. Total bilirubin (TB), unbound bilirubin (UB), and ibuprofen concentrations were measured before, 1 hour, and 6 hours after the first dose; before and 1 hour after the second dose; and 72 hours after the beginning of treatment. The infants were screened by auditory brainstem responses and by neurologic examination at term.
  
  
  RESULTS
  At baseline, TB, UB, apparent binding affinity of albumin (Ka), and albumin concentrations were 6.0±1.6 mg/dL, 1.9±2.2 μg/dL, 14.1±5.8 L·μmol(-1), and 28.7±2.3 g/L, respectively. Ibuprofen treatment had no effect on TB, UB, or Ka values. No correlation between UB or Ka and ibuprofen concentrations was found. No neurologic symptoms or significant modifications of auditory brainstem responses were observed at term.
  
  
  CONCLUSIONS
  Ibuprofen (10-5-5 mg/kg) did not displace bilirubin in preterm infants with a baseline TB concentration <8.8 mg/dL.
authors.affiliation: Neonatology Service, Louis Mourier Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Colombes, Denis Diderot University, Paris, France. luc.desfrere@lmr.aphp.fr
authors.forename: Luc
authors.initials: L
authors.lastname: Desfrere
authors.forename: Celine
authors.initials: C
authors.lastname: Thibaut
authors.forename: Yves
authors.initials: Y
authors.lastname: Kibleur
authors.forename: Alexandre
authors.initials: A
authors.lastname: Barbier
authors.forename: Cecile
authors.initials: C
authors.lastname: Bordarier
authors.forename: Guy
authors.initials: G
authors.lastname: Moriette
mesh_terms: D000418:Albumins / Q000378:metabolism; D001663:Bilirubin / Q000097:blood*; D016861:Cyclooxygenase Inhibitors / Q000008:administration & dosage* / Q000494:pharmacology*; D004305:Dose-Response Relationship, Drug; D004374:Ductus Arteriosus, Patent / Q000097:blood / Q000188:drug therapy*; D016057:Evoked Potentials, Auditory, Brain Stem / Q000187:drug effects; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000008:administration & dosage* / Q000494:pharmacology*; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood; D007235:Infant, Premature, Diseases / Q000097:blood / Q000188:drug therapy; D008297:Male; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000418:Albumins; D016861:Cyclooxygenase Inhibitors; D001663:Bilirubin; D007052:Ibuprofen