title: Intravenous paracetamol with a lower dose is also effective for the treatment of patent ductus arteriosus in pre-term infants.
abstract: BACKGROUND
  Haemodynamically significant patent ductus arteriosus is a significant cause of morbidity and mortality in pre-term infants. This retrospective study was conducted to investigate the usefulness of lower-dose paracetamol for the treatment of patent ductus arteriosus in pre-term infants.
  
  
  METHODS
  A total of 13 pre-term infants who received intravenous paracetamol because of contrindications or side effects to oral ibuprofen were retrospectively enrolled. In the first patient, the dose regimen was 15 mg/kg/dose, every 6 hours. As the patient developed significant elevation in transaminase levels, the dose was decreased to 10 mg/kg/dose, every 8 hours in the following 12 patients. Echocardiographic examination was conducted daily. In case of closure, it was repeated after 2 days and when needed thereafter in terms of reopening.
  
  
  RESULTS
  A total of 13 patients received intravenous paracetamol. Median gestational age was 29 weeks ranging from 24 to 31 weeks and birth weight was 950 g ranging from 470 to 1390 g. The median postnatal age at the first intravenous paracetamol dose was 3 days ranging from 2 to 9 days. In 10 of the 13 patients (76.9%), patent ductus arteriosus was closed at the median 2nd day of intravenous paracetamol ranging from 1 to 4 days. When the patient who developed hepatotoxicity was eliminated, the closure rate was found to be 83.3% (10/12).
  
  
  CONCLUSIONS
  Intravenous paracetamol may be a useful treatment option for the treatment of patent ductus arteriosus in pre-term infants with contrindication to ibuprofen. In our experience, lower-dose paracetamol is effective in closing the patent ductus arteriosus in 83.3% of the cases.
authors.affiliation: 1Division of Neonatology,Ataturk University Medical Faculty,Erzurum,Turkey.
authors.forename: Kadir Şerafettin
authors.initials: KŞ
authors.lastname: Tekgündüz
authors.affiliation: 2Department of Pediatric Cardiology,Ataturk University Medical Faculty,Erzurum,Turkey.
authors.forename: Naci
authors.initials: N
authors.lastname: Ceviz
authors.affiliation: 1Division of Neonatology,Ataturk University Medical Faculty,Erzurum,Turkey.
authors.forename: İbrahim
authors.initials: İ
authors.lastname: Caner
authors.affiliation: 2Department of Pediatric Cardiology,Ataturk University Medical Faculty,Erzurum,Turkey.
authors.forename: Haşim
authors.initials: H
authors.lastname: Olgun
authors.affiliation: 1Division of Neonatology,Ataturk University Medical Faculty,Erzurum,Turkey.
authors.forename: Yaşar
authors.initials: Y
authors.lastname: Demirelli
authors.affiliation: 2Department of Pediatric Cardiology,Ataturk University Medical Faculty,Erzurum,Turkey.
authors.forename: Canan
authors.initials: C
authors.lastname: Yolcu
authors.affiliation: 2Department of Pediatric Cardiology,Ataturk University Medical Faculty,Erzurum,Turkey.
authors.forename: İrfan Oğuz
authors.initials: İO
authors.lastname: Şahin
authors.affiliation: 1Division of Neonatology,Ataturk University Medical Faculty,Erzurum,Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kara
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage* / Q000009:adverse effects; D061605:Administration, Intravenous; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage* / Q000009:adverse effects; D001724:Birth Weight; D004334:Drug Administration Schedule; D004374:Ductus Arteriosus, Patent / Q000188:drug therapy*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D018712:Analgesics, Non-Narcotic; D000082:Acetaminophen
keywords: Intravenous; paracetamol; patent ductus arteriosus; premature infant