title: Efficacy and safety of rectal ibuprofen for patent ductus arteriosus closure in very low birth weight preterm infants.
abstract: BACKGROUND
  To compare rectal ibuprofen with oral ibuprofen for the closure of hemodynamically significant patent ductus arteriosus (hsPDA) in very low birth weight (VLBW) preterm infants.
  
  
  METHODS
  In a prospective, randomized study, 72 VLBW infants who had hsPDA received either rectal or oral ibuprofen. The plasma concentration of ibuprofen and renal functions were determined in both groups by the high-performance liquid chromatography (HPLC) method and cystatin-C (cys-C), respectively.
  
  
  RESULTS
  The hsPDA closure rate of the group that received rectal ibuprofen was similar to oral ibuprofen (86.1% versus 83.3%) after the first course of the treatment (p = 0.745). A statistically significant difference was identified between the mean plasma cys-C levels before and after treatment in both the rectal and oral ibuprofen groups (p = 0.004 and p< 0.001, respectively). The mean plasma ibuprofen concentration was similar in both groups after the first dose (rectal 44.06 ± 12.4; oral, 48.28 ± 22.8) and the third dose (rectal, 45.34 ± 24.3; oral, 48.94 ± 24.8) (p > 0.05 for all values).
  
  
  CONCLUSIONS
  Rectal ibuprofen is as effective as oral ibuprofen for hsPDA closure in VLBW infants. The rise in the cys-C level with rectal and oral treatment shows that patients with borderline renal function should be evaluated and followed closely.
authors.affiliation: a Department of Pediatrics, Division of Neonatology , Yuzuncu Yil University School of Medicine , Van , Turkey.
authors.forename: Nihat
authors.initials: N
authors.lastname: Demir
authors.affiliation: a Department of Pediatrics, Division of Neonatology , Yuzuncu Yil University School of Medicine , Van , Turkey.
authors.forename: Erdal
authors.initials: E
authors.lastname: Peker
authors.affiliation: b Department of Pediatrics, Division of Cardiology , Yuzuncu Yil University School of Medicine , Van , Turkey.
authors.forename: İbrahim
authors.initials: İ
authors.lastname: Ece
authors.affiliation: c Department of Medical Biochemistry , Yuzuncu Yil University School of Medicine , Van , Turkey.
authors.forename: Ragıp
authors.initials: R
authors.lastname: Balahoroğlu
authors.affiliation: a Department of Pediatrics, Division of Neonatology , Yuzuncu Yil University School of Medicine , Van , Turkey.
authors.forename: Oğuz
authors.initials: O
authors.lastname: Tuncer
mesh_terms: D000284:Administration, Oral; D000285:Administration, Rectal; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D016861:Cyclooxygenase Inhibitors / Q000008:administration & dosage*; D055316:Cystatin C / Q000097:blood; D004374:Ductus Arteriosus, Patent / Q000188:drug therapy*; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000008:administration & dosage* / Q000097:blood; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D008297:Male; D011446:Prospective Studies; D011897:Random Allocation; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D016861:Cyclooxygenase Inhibitors; D055316:Cystatin C; D007052:Ibuprofen
keywords: Ibuprofen; oral; patent ductus arteriosus; preterm; rectal