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Research Article Open access CC BY 4.0

Paracetamol vs Ibuprofen in Hemodynamically Significant Patent Ductus Arteriosus (HsPDA) in Preterms: A Randomized Controlled Trial

Hinal A Sinol, Alpa N Parekh, Jayendra R Gohil, Mehul Gosai

Asian Journal of Pediatric Research · pp. 6–13 · Published 7 Jan 2020

10.9734/ajpr/2020/v3i130118

Abstract

Background and Objective: Hemodynamically significant patent ductus arteriosus (HsPDA) is a common cause of morbidity in preterm infants. Indomethacin and Ibuprofen, which are cyclo-oxygenase (COX) 1, 2 inhibitors are commonly used drugs for closure of HsPDA. As, Ibuprofen has several contraindications, we designed study using oral paracetamol (a peroxidase inhibitor) and compared with oral ibuprofen, for efficacy and safety in relation to closure of HsPDA in preterm infants. Methods: 140 preterm infants (gestational age less than 32 weeks) with HsPDA (confirmed by 2D Echo) were randomly assigned in two groups and received first course of either oral paracetamol (70) or ibuprofen (70). The need for a second course was determined by 2D Echo evaluation. Parameters studied were rate of ductal closure, any adverse effects and discharge rate. Results: Both groups were similar in term of ductal closure after first course (p=0.46) and second course (p=0.59). However, 22 from Ibuprofen group and only 2 from PCM group developed adverse effects (p<0.001). From paracetamol group 58 were discharged, and 12 died; while from ibuprofen group 46 discharged, 24 died (p=0.03). Conclusion: Paracetamol for HsPDA in preterm neonates was associated with good efficacy and better safety; and less deaths, as compared to ibuprofen.

Patent ductus arteriosus paracetamol ibuprofen preterm.

References (8)

  1. 1 Ductal Closure With Paracetamol: A Surprising New Approach to Patent Ductus Arteriosus Treatment [DOI]
  2. 2 Mechanisms Regulating the Ductus Arteriosus [DOI]
  3. 3 Comparison of Oral Paracetamol versus Ibuprofen in Premature Infants with Patent Ductus Arteriosus: A Randomized Controlled Trial [DOI]
  4. 4 Efficacy and Safety of Oral Versus Intravenous Ibuprofen in Very Low Birth Weight Preterm Infants with Patent Ductus Arteriosus [DOI]
  5. 5 Early versus late indomethacin treatment for patent ductus arteriosus in premature infants with respiratory distress syndrome [DOI]
  6. 6 A blinded comparison of clinical and echocardiographic evaluation of the preterm infant for patent ductus arteriosus [DOI]
  7. 7 Does Ibuprofen Increase Neonatal Hyperbilirubinemia? [DOI]
  8. 8 An interesting observation of PDA closure with oral paracetamol in preterm neonates [DOI]

Cited by 7

A Network Meta-Analysis of Intravenous Versus Oral Acetaminophen for Patent Ductus Arteriosus

Abiola Olowoyeye, Onyinye Nnamdi-Nwosu, Maika Manalastas · Pediatric Cardiology · 2022

Paracetamol versus ibuprofen as first-line treatment for patent ductus arteriosus: An updated systematic review and meta-analysis of randomized controlled trials

I Nyoman Windiana, Nyoman Suciawan, Ida Ayu Putu Purnamawati · Journal of Neonatal Nursing · 2025

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