title: High-dose ibuprofen for patent ductus arteriosus in extremely preterm infants: a randomized controlled study.
abstract: Our aim was to assess the hypothesis that a high-dose regimen of ibuprofen is more effective than the standard-dose regimen in closing patent ductus arteriosus (PDA) without increasing adverse effects. Infants of gestational age <29 weeks, with respiratory distress syndrome (RDS) and echocardiographic evidence of significant PDA at 12-24 h of life, were randomized to receive a standard (10-5-5 mg/kg/day) or high-dose (20-10-10 mg/kg/day) course of ibuprofen. We studied 70 infants, 35 of whom received the standard dose of ibuprofen and the other 35 the high dose. Of the infants treated with the standard-dose regimen, 37% had persistent PDA as compared with 14% of those treated with the high-dose regimen (P = 0.03). No differences in the occurrence of adverse effects were observed between the two groups. The high-dose ibuprofen regimen is more effective than the standard-dose regimen in closing PDA in preterm infants <29 weeks of gestation without increasing the adverse effect rate.
authors.affiliation: Department of Surgical and Medical Critical Care, Section of Neonatology, Careggi University Hospital of Florence, Florence, Italy. cdani@unifi.It
authors.forename: C
authors.initials: C
authors.lastname: Dani
authors.forename: V
authors.initials: V
authors.lastname: Vangi
authors.forename: G
authors.initials: G
authors.lastname: Bertini
authors.forename: S
authors.initials: S
authors.lastname: Pratesi
authors.forename: I
authors.initials: I
authors.lastname: Lori
authors.forename: F
authors.initials: F
authors.lastname: Favelli
authors.forename: R
authors.initials: R
authors.lastname: Ciuti
authors.forename: A
authors.initials: A
authors.lastname: Bandinelli
authors.forename: C
authors.initials: C
authors.lastname: Martano
authors.forename: P
authors.initials: P
authors.lastname: Murru
authors.forename: H
authors.initials: H
authors.lastname: Messner
authors.forename: F
authors.initials: F
authors.lastname: Schena
authors.forename: F
authors.initials: F
authors.lastname: Mosca
mesh_terms: D004305:Dose-Response Relationship, Drug; D004374:Ductus Arteriosus, Patent / Q000188:drug therapy* / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000008:administration & dosage*; D052577:Infant, Extremely Low Birth Weight / Q000502:physiology; D007231:Infant, Newborn; D008297:Male
chemical_list: D007052:Ibuprofen