title: Intravenous paracetamol treatment in the management of patent ductus arteriosus in extremely low birth weight infants.
abstract: BACKGROUND
  Treatment options for the closure of a hemodynamically significant patent ductus arteriosus (hsPDA) include medical therapy such as ibuprofen and indomethacin and surgical ligation.
  
  
  OBJECTIVE
  To evaluate the efficacy of intravenous paracetamol in preterm infants with hsPDA whose feeding was contraindicated or had feeding intolerance.
  
  
  METHODS
  Preterm infants with hsPDA were started on intravenous paracetamol treatment with parental consent. Paracetamol was administered at a dose of 60 mg/kg/day, in four divided doses, for a period of 3 days. In the absence of closure of hsPDA, treatment was extended up to 6 days, after which echocardiographic examination was performed.
  
  
  RESULTS
  A total of 10 preterm infants were included in the study with a median gestational age of 27(4/7) weeks (minimum-maximum: 24-29) and a median birth weight of 775 g (590-990). The first dose of intravenous paracetamol was given after a median of 6 days (2-15). On echocardiographic examination, median internal ductal diameter was 2 mm (1.5-3), with a median left atrium-to-aortic root ratio of 1.95 (1.6-2.2). Intravenous paracetamol resulted in successful closure of hsPDA in all patients.
  
  
  CONCLUSIONS
  This study is the first case series in the literature which used intravenous paracetamol treatment for hsPDA. We believe that intravenous paracetamol could be used as an alternative drug for infants. Further prospective randomized-controlled trials are needed to evaluate the efficacy of intravenous paracetamol for the closure of hsPDA.
authors.affiliation: Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey. dryekta @ gmail.com
authors.forename: Mehmet Yekta
authors.initials: MY
authors.lastname: Oncel
authors.forename: Sadik
authors.initials: S
authors.lastname: Yurttutan
authors.forename: Halil
authors.initials: H
authors.lastname: Degirmencioglu
authors.forename: Nurdan
authors.initials: N
authors.lastname: Uras
authors.forename: Nahide
authors.initials: N
authors.lastname: Altug
authors.forename: Omer
authors.initials: O
authors.lastname: Erdeve
authors.forename: Ugur
authors.initials: U
authors.lastname: Dilmen
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage* / Q000097:blood; D002317:Cardiovascular Agents / Q000008:administration & dosage* / Q000097:blood; D016009:Chi-Square Distribution; D004334:Drug Administration Schedule; D004374:Ductus Arteriosus, Patent / Q000000981:diagnostic imaging / Q000188:drug therapy*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007275:Injections, Intravenous; D008297:Male; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D002317:Cardiovascular Agents; D000082:Acetaminophen