Preliminary study on the effectiveness of oral ibuprofen in treating persistent Patent Ductus Arteriosus (PDA) for respiratory distress of premature neonates

ABSTRACT

Background: PDA is an especially common pathological condition in premature neonates because of the anatomical structural immaturity of the cardiovascular system. There are evidence for the effectiveness of ibuprofen for closing persistent ductus arteriosus, with few adverse effects. Objectives: To determine whether oral ibuprofen treatment is effective and safe in the closure of PDA in premature infants with respiratory distress syndrome. Subjects and methods: The prospective study was conducted on premature newborns with PDA who were presented at the Department of Neonatology, National Hospital of Pediatrics. Results: A total of 32 neonates were eligible for the study. Ductal closure was achieved in 22 newborns (68.6%), the ductus was persistent after 6 doses in 8 cases (25.1%), 2 newborns (6.3%) suffered from ductal reopening after closure (after 1 and 2 doses). PDA closure was achieved with 1 dose of ibuprofen in 7 cases, 2 doses in 9, 3 doses in 4 and more than 4 doses in 4 cases. The survival rate was 81.2% (26 out of 32). 6 patients (18.8%) died from severe respiratory distress and very low birth weight (2 cases), Klebsiella sepsis (4 cases). Mortality is higher in the closure failure group (p<0.05). Conclusions: Oral ibuprofen suspension can be considered as an effective and safe alternative for PDA closure in premature newborns. Larger comparative studies is required to confirm these results.