title: Ductal closure with intravenous paracetamol: a new approach to patent ductus arteriosus treatment.
abstract: OBJECTIVE
  Indomethacin and ibuprofen are commonly used in the treatment of hemodynamically significant patent ductus arteriosus (hsPDA). These drugs are associated with serious adverse events, including gastrointestinal perforation, renal failure and bleeding. The role of paracetamol has been proposed for the treatment of PDA.
  
  
  METHODS
  We report a series of 11 neonates (birth weight: 415-1580 g; gestational age: 23-30.3 weeks) who were treated with paracetamol for a hsPDA. Neonates with hsPDA were treated with paracetamol in the presence of contraindications to ibuprofen or indomethacin. The condition of significant PDA was defined by the presence of at least one of the following criteria: internal ductal diameter # 1.4 mm/kg body weight, left atrium (LA)-to-aortic (Ao) root ratio > 1.4, unrestrictive pulsatile transductal flow, reverse or absent diastolic flow in the descending aorta along with clinical findings. Intravenous (IV) paracetamol was given at doses 15 mg/kg every 6 h for three days.
  
  
  RESULTS
  Successful ductal closure was achieved in 10 out of 11 babies (90.9%). No adverse or side effects were observed during the treatment.
  
  
  CONCLUSIONS
  On the basis of these results, paracetamol could be considered as a promising and safe therapy for the treatment of PDA in preterm infants.
authors.affiliation: a Division of Neonatology and.
authors.forename: Asli
authors.initials: A
authors.lastname: Memisoglu
authors.affiliation: a Division of Neonatology and.
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Alp Ünkar
authors.affiliation: b Division of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine , Marmara University , Istanbul , Turkey.
authors.forename: Nilufer
authors.initials: N
authors.lastname: Cetiner
authors.affiliation: b Division of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine , Marmara University , Istanbul , Turkey.
authors.forename: Figen
authors.initials: F
authors.lastname: Akalın
authors.affiliation: a Division of Neonatology and.
authors.forename: Hulya
authors.initials: H
authors.lastname: Ozdemir
authors.affiliation: a Division of Neonatology and.
authors.forename: Hülya Selva
authors.initials: HS
authors.lastname: Bilgen
authors.affiliation: a Division of Neonatology and.
authors.forename: Eren
authors.initials: E
authors.lastname: Ozek
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use*; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use*; D004374:Ductus Arteriosus, Patent / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male
chemical_list: D018712:Analgesics, Non-Narcotic; D000082:Acetaminophen
keywords: Paracetamol; patent ductus arteriosus; premature