title: Randomised controlled clinical trial of standard versus echocardiographically guided ibuprofen treatment for patent ductus arteriosus in preterm infants: a pilot study.
abstract: OBJECTIVE
  The aim of this study was to explore the efficacy of echocardiographically guided (EchoG) pharmacological closure of the ductus arteriosus in reducing the number of required ibuprofen doses without increasing the reopening rate.
  
  
  METHODS
  We performed a randomised controlled trial that included 49 infants with a duct ≥1.5 mm who were randomised to either EchoG or standard ibuprofen treatment. Echocardiography was serially performed on days 1, 2, 3, 4, 7, 10 and 17 after inclusion. The primary outcome was the ductus reopening rate, and an intention-to-treat analysis was performed.
  
  
  RESULTS
  Twenty-eight (EchoG treatment) and 21(standard treatment) infants were enrolled (27.2 versus 27.3 weeks, p = 0.3). The patients received 2 (1-5.7) and 3 (3-4) doses of ibuprofen in the EchoG and standard treatment groups, respectively (p = 0.04) and experienced a similar ductus reopening rate (11% versus 5%, p = 0.6).
  
  
  CONCLUSIONS
  Echocardiographically guided ibuprofen treatment of patent ductus arteriosus is feasible and reduces unnecessary doses of medication.
authors.affiliation: Department of Neonatology, La Paz University Hospital , Madrid , Spain .
authors.forename: María Carmen
authors.initials: MC
authors.lastname: Bravo
authors.forename: Fernando
authors.initials: F
authors.lastname: Cabañas
authors.forename: Joan
authors.initials: J
authors.lastname: Riera
authors.forename: Elia
authors.initials: E
authors.lastname: Pérez-Fernández
authors.forename: José
authors.initials: J
authors.lastname: Quero
authors.forename: Jesús
authors.initials: J
authors.lastname: Pérez-Rodríguez
authors.forename: Adelina
authors.initials: A
authors.lastname: Pellicer
mesh_terms: D004305:Dose-Response Relationship, Drug; D004374:Ductus Arteriosus, Patent / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D004452:Echocardiography; D005260:Female; D005865:Gestational Age; D006801:Humans; D007052:Ibuprofen / Q000008:administration & dosage*; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D057194:Intention to Treat Analysis; D008297:Male; D010865:Pilot Projects; D059039:Standard of Care
chemical_list: D007052:Ibuprofen
keywords: Cyclooxygenase inhibitor; functional echocardiography; newborn