Factors affecting the effectiveness of oral ibuprofen in the treatment of patent ductus arteriosus in preterm infants
- 5 January 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in International Journal of Clinical Pharmacy
- Vol. 43 (4), 1074-1081
- https://doi.org/10.1007/s11096-020-01219-6
Abstract
Background Data on the effectiveness of oral ibuprofen treatment for patent ductus arteriosus are limited, and the factors affecting its effectiveness remain unclear. Objective The aim was to identify the potential factors affecting the clinical effectiveness of oral ibuprofen in preterm infants. Setting Neonatal intensive care unit in a prefecture-level maternal and child healthcare hospital in China. Method Over a 5-years period, the medical records of 327 preterm infants with patent ductus arteriosus who were admitted to the neonatal intensive care unit of our hospital to receive a single course of oral ibuprofen were retrospectively reviewed. Main outcome measures The prevalence of risk factors affecting the effectiveness of oral ibuprofen. Results In total, 201 (61.47%) preterm infants were considered to have undergone “effective therapy” and classified accordingly, whereas 11 (3.36%) showed certain adverse events. Factors affecting therapeutic effectiveness were postnatal age at the initiation of treatment and Day 1/Day 0 ratio of urine output/fluid intake during the treatment course, with odds ratios of 0.892 (95% CI: 0.835–0.953; P = 0.001) and 0.473 (95% CI 0.265–0.845; P = 0.011), respectively. Conclusion A single course of oral ibuprofen for patent ductus arteriosus closure among preterm infants is effective and safe. Preterm infants with postnatal age of ≤ 9 days at the initiation of treatment and Day 1/Day 0 ratio of ≤ 0.708 of the urine output/fluid intake during the treatment course can be considered predictors of effectiveness of patent ductus arteriosus.Keywords
Funding Information
- Natural Science Foundation of Ningbo (2018A610245)
- Zhejiang Province Public Welfare Technology Application Research Project (2017C35010)
- Medical Health Science and Technology Project of Zhejiang Provincial Health Commission (2020KY279)
This publication has 26 references indexed in Scilit:
- Ibuprofen for the treatment of patent ductus arteriosus in preterm or low birth weight (or both) infantsEmergencias, 2020
- Mandatory Closure Versus Nonintervention for Patent Ductus Arteriosus in Very Preterm InfantsThe Journal of Pediatrics, 2016
- Repeated Courses of Oral Ibuprofen in Premature Infants with Patent Ductus Arteriosus: Efficacy and SafetyPediatrics & Neonatology, 2016
- The role of patent ductus arteriosus and its treatments in the development of bronchopulmonary dysplasiaSeminars in Perinatology, 2013
- Effectiveness and Safety of Indomethacin versus Ibuprofen for the Treatment of Patent Ductus Arteriosus in Preterm InfantsAmerican Journal of Perinatology, 2013
- Functional echocardiography in staging for ductal disease severityEuropean Journal of Pediatrics, 2012
- Treatment of Patent Ductus Arteriosus and Neonatal Mortality/Morbidities: Adjustment for Treatment Selection BiasThe Journal of Pediatrics, 2012
- Failure of Ductus Arteriosus Closure Is Associated With Increased Mortality in Preterm InfantsPEDIATRICS, 2009
- Patent Ductus Arteriosus and Its Treatment as Risk Factors for Neonatal and Neurodevelopmental MorbidityPEDIATRICS, 2007
- Neurosensory Impairment after Surgical Closure of Patent Ductus Arteriosus in Extremely Low Birth Weight Infants: Results from the Trial of Indomethacin Prophylaxis in PretermsThe Journal of Pediatrics, 2007