title: Efficacy of paracetamol for the treatment of patent ductus arteriosus in preterm neonates.
abstract: Inhibitors of the cyclo-oxygenase component of prostaglandin-H2 synthetase, namely indomethacin and ibuprofen, are commonly used in the treatment of hemodynamically significant patent ductus arteriosus. These drugs are associated with serious adverse events, including gastrointestinal perforation, renal failure and bleeding. The role of paracetamol, an inhibitor of the peroxidase component of prostaglandin-H2 synthetase, has been proposed for the treatment of patent ductus arteriosus. We report a series of 8 neonates (birth weight: 724 ± 173 g; gestational age: 26 ± 2 weeks) treated with paracetamol for a hemodynamically significant patent ductus arteriosus, because of contraindications to ibuprofen or indomethacin. Successful closure was achieved in 6 out of 8 babies (75%). Median ductal diameter was significantly reduced after treatment (from 1.2 mm, range 1.0-2.5 mm to 0.6 mm, range 0.0-2.5 mm, p = 0.038). No adverse or side effects were observed during treatment. On the basis of these results, paracetamol could be considered a promising and safe therapy for the treatment of patent ductus arteriosus in neonates.
authors.affiliation: Department of Gynecology-Obstetrics and Perinatal Medicine, University "La Sapienza", Viale del Policlinico 155, 00161 Rome, Italy. gianluca.terrin@uniroma1.it.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Terrin
authors.forename: Francesca
authors.initials: F
authors.lastname: Conte
authors.forename: Antonella
authors.initials: A
authors.lastname: Scipione
authors.forename: Erica
authors.initials: E
authors.lastname: Bacchio
authors.forename: Maria Giulia
authors.initials: MG
authors.lastname: Conti
authors.forename: Rosalia
authors.initials: R
authors.lastname: Ferro
authors.forename: Flavia
authors.initials: F
authors.lastname: Ventriglia
authors.forename: Mario
authors.initials: M
authors.lastname: De Curtis
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage*; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage; D001724:Birth Weight; D004305:Dose-Response Relationship, Drug; D004374:Ductus Arteriosus, Patent / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000188:drug therapy*; D008297:Male; D012189:Retrospective Studies
chemical_list: D018712:Analgesics, Non-Narcotic; D000082:Acetaminophen