Does ibuprofen treatment in patent ductus arteriosus alter oxygen free radicals in premature infants?
Introduction Ibuprofen is used widely to close patent ductus arteriosus in preterm infants. The anti-inflammatory activity of ibuprofen may also be partly due to its ability to scavenge reactive oxygen species and reactive nitrogen species. We evaluated the interaction between oxidative status and the medical treatment of patent ductus arteriosus with two forms of ibuprofen. Materials and methods This study enrolled newborns of gestational age ⩽32 weeks, birth weight ⩽1500 g, and postnatal age 48-96 hours, who received either intravenous or oral ibuprofen to treat patent ductus arteriosus. Venous blood was sampled before ibuprofen treatment from each patient to determine antioxidant and oxidant concentrations. Secondary samples were collected 24 hours after the end of the treatment. Total oxidant status and total antioxidant capacity were measured using Erel's method.


RESULTS
This prospective randomised study enrolled 102 preterm infants with patent ductus arteriosus. The patent ductus arteriosus closure rate was significantly higher in the oral ibuprofen group (84.6 versus 62%) after the first course of treatment (p=0.011). No significant difference was found between the pre- and post-treatment total oxidant status and total antioxidant capacity in the groups. Discussion Ibuprofen treatment does not change the total oxidant status or total antioxidant capacity. We believe that the effect of ibuprofen treatment in inducing ischaemia overcomes the scavenging effect of ibuprofen.
Zekai Tahir Burak Maternity Teaching Hospital,Neonatal Intensive Care Unit,Ankara,Turkey.
Melek
M
Akar
Zekai Tahir Burak Maternity Teaching Hospital,Neonatal Intensive Care Unit,Ankara,Turkey.
Tulin G
TG
Yildirim
Zekai Tahir Burak Maternity Teaching Hospital,Neonatal Intensive Care Unit,Ankara,Turkey.
Gonca
G
Sandal
Zekai Tahir Burak Maternity Teaching Hospital,Neonatal Intensive Care Unit,Ankara,Turkey.
Senol
S
Bozdag
Zekai Tahir Burak Maternity Teaching Hospital,Neonatal Intensive Care Unit,Ankara,Turkey.
Omer
O
Erdeve
Zekai Tahir Burak Maternity Teaching Hospital,Neonatal Intensive Care Unit,Ankara,Turkey.
Nahide
N
Altug
Zekai Tahir Burak Maternity Teaching Hospital,Neonatal Intensive Care Unit,Ankara,Turkey.
Nurdan
N
Uras
Zekai Tahir Burak Maternity Teaching Hospital,Neonatal Intensive Care Unit,Ankara,Turkey.
Serife S
SS
Oguz
Zekai Tahir Burak Maternity Teaching Hospital,Neonatal Intensive Care Unit,Ankara,Turkey.
Ugur
U
Dilmen
D000284:Administration, Oral; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D000975:Antioxidants / Q000378:metabolism; D015415:Biomarkers / Q000097:blood; D004305:Dose-Response Relationship, Drug; D004374:Ductus Arteriosus, Patent / Q000097:blood / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007052:Ibuprofen / Q000008:administration & dosage*; D007231:Infant, Newborn; D007234:Infant, Premature; D007262:Infusions, Intravenous; D008297:Male; D018384:Oxidative Stress / Q000187:drug effects*; D011446:Prospective Studies; D017382:Reactive Oxygen Species / Q000097:blood*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000975:Antioxidants; D015415:Biomarkers; D017382:Reactive Oxygen Species; D007052:Ibuprofen
Ibuprofen; oxidative stress; patent ductus arteriosus; prematurity