Adding Paracetamol to Ibuprofen for the Treatment of Patent Ductus Arteriosus in Preterm Infants: A Double-Blind, Randomized, Placebo-Controlled Pilot Study

American Journal of Perinatology
Ori HochwaldAmir Kugelman

Abstract

The objective of this study was to compare the closure rate of hemodynamically significant patent ductus arteriosus (hsPDA) of intravenous ibuprofen + paracetamol (acetaminophen) versus ibuprofen + placebo, in preterm infants of 24 to 316/7 weeks postmenstrual age. This is a single-center, double-blind, randomized controlled pilot study. Infants were assigned for treatment with either intravenous ibuprofen + paracetamol (n = 12) or ibuprofen + placebo (n = 12). There was no statistical difference in baseline characteristics of the two groups. Echocardiography parameters were comparable before treatment in both groups. There was a trend toward higher hsPDA closure rate in the paracetamol group in comparison to the placebo group (83 vs. 42%, p = 0.08). No adverse effects, clinical or laboratory, were associated with adding paracetamol. Our pilot study was unable to detect a beneficial effect by adding intravenous paracetamol to ibuprofen for the treatment of hsPDA. Larger prospective studies are needed to explore the positive tendency suggested by our results and to assure safety.

Citations

Apr 7, 2018·The Cochrane Database of Systematic Reviews·Arne Ohlsson, Prakeshkumar S Shah
Mar 10, 2019·Journal of Perinatology : Official Journal of the California Perinatal Association·Melissa LiebowitzRonald I Clyman
May 22, 2020·European Journal of Clinical Pharmacology·Outi AikioMikko Hallman
Mar 2, 2021·Frontiers in Pediatrics·Sarah ParkersonShyam Sathanandam
May 2, 2021·NeoReviews·Maika ManalastasSachin Amin
Oct 24, 2020·Pediatrics·Shannon E G HamrickGeorg Hansmann

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