title: May we use ibuprofen as doses against courses in the treatment of patent ductus arteriosus in premature infants?
abstract: OBJECTIVE
  We aimed to investigate the efficacy of ibuprofen doses in closing patent ductus arteriosus (PDA) and the possibility of reducing drug-related complications by reducing dose number.
  
  
  METHODS
  We performed a prospective study with 60 premature infants (≤33 weeks) who were treated with enteral ibuprofen for hsPDA. Echocardiographic examinations were performed before each dose. Treatment was stopped when PDA was closed and patients were followed for reopening and complications.
  
  
  RESULTS
  Rates of closure were 28.3%, 44.1%, 54.1%, 36.3%, 42.8% and 50.0% with the 1st, 2nd, 3rd, 4th, 5th and 6th doses. No closure was observed with 7th, 8th and 9th doses. Reopening was observed only in patients whose PDA closed with the 1st (3.3%), 2nd (1.6%) and 3rd (1.6%) doses. PDA diameters were higher in patients who required >4 doses. Complications were rare (6.6%) but unrelated with dose number.
  
  
  CONCLUSIONS
  We conclude that it is possible to minimize ibuprofen exposure and achieve high closure rates of PDA in premature infants by performing echocardiography before each dose. PDA diameter should be used to estimate the duration of treatment. This approach is not effective in reducing complication rates and must be performed in attention to reopening especially for the first three doses.
authors.affiliation: a Division of Pediatric Cardiology and.
authors.forename: İrfan Oğuz
authors.initials: İO
authors.lastname: Şahin
authors.affiliation: b Division of Neonatology, Department of Pediatrics, Faculty of Medicine , Atatürk University , Erzurum , Turkey.
authors.forename: Nurdan
authors.initials: N
authors.lastname: Dinlen Fettah
authors.affiliation: b Division of Neonatology, Department of Pediatrics, Faculty of Medicine , Atatürk University , Erzurum , Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kara
authors.affiliation: b Division of Neonatology, Department of Pediatrics, Faculty of Medicine , Atatürk University , Erzurum , Turkey.
authors.forename: Yaşar
authors.initials: Y
authors.lastname: Demirelli
authors.affiliation: b Division of Neonatology, Department of Pediatrics, Faculty of Medicine , Atatürk University , Erzurum , Turkey.
authors.forename: Kadir Şerafettin
authors.initials: KŞ
authors.lastname: Tekgündüz
authors.affiliation: a Division of Pediatric Cardiology and.
authors.forename: Canan
authors.initials: C
authors.lastname: Yolcu
authors.affiliation: a Division of Pediatric Cardiology and.
authors.forename: Haşim
authors.initials: H
authors.lastname: Olgun
authors.affiliation: a Division of Pediatric Cardiology and.
authors.forename: Naci
authors.initials: N
authors.lastname: Ceviz
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D004374:Ductus Arteriosus, Patent / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007052:Ibuprofen / Q000008:administration & dosage*; D007231:Infant, Newborn; D007234:Infant, Premature; D011446:Prospective Studies; D012008:Recurrence
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D007052:Ibuprofen
keywords: Echocardiography; ibuprofen; patent ductus arteriosus; premature infants