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Indomethacin as a Rescue Therapy for Patent Ductus Arteriosus in Extremely Premature Infants after Failed Ibuprofen Treatment

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submitted on 2023-09-26, 09:37 and posted on 2023-10-12, 09:15 authored by Amal Sabouni, Ashraf Gad, Alaa ElMasry, Fawzia Elghabawy, Sheikha Alnaimi

Hemodynamically significant patent ductus arteriosus (hsPDA) is a major cause of neonatal morbidity and mortality in extremely low birth weight (ELBW) infants. The optimal management of PDA in these infants is unsettled; however, medical treatment with cyclooxygenases (COX) inhibitors such as ibuprofen or indomethacin is the current practice in most neonatal intensive care units (NICU). Most studies show equal efficacy of both drugs but with a better side effect profile with ibuprofen treatment. While most PDAs close after one 3-day course of either medicine, a repeat course may be necessary before considering surgical ligation for those who remain with hsPDAs. In our practice, we administer one or two courses of ibuprofen followed by a single course of indomethacin if the PDA has not shown closure or decrease in size on the echocardiogram (echo) exam. The goal of this study is to assess PDA close status by echo with this current regimen. We aim to find the success rates of indomethacin treatment for hsPDA following unsuccessful ibuprofen treatment.

History

Language

  • English

Publication Year

  • 2023

License statement

This Item is licensed under the Creative Commons Attribution 4.0 International License

Institution affiliated with

  • Hamad Medical Corporation
  • Women's Wellness and Research Center - HMC